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Machinery Murmur, Carotid Dissection, Doppler Ultrasonography, Central Nervous SystemStroke is the loss of brain function due to blocked blood circulation to the brain. Strokes may be caused by an uncommon type of narrowing, obstruction, or leak in the lining of the carotid artery. This leaking of blood into the artery wall (dissection) may cause a clot to form, reducing blood flow and raising the risk of stroke.
The leak may arise from an injury to the neck, which means strokes caused by carotid dissection may occur in young people as well as older people.


  • Pain in the neck, which may travel to the eye
  • Pulsing in the ears
  • Weakness or total inability to move a body part
  • Numbness, loss of sensation, or tingling
  • Horner's syndrome
    1. Eyelid drooping
    2. Abnormal pupils
    3. Abnormal facial sweating
  • Trouble seeing, may occur in one or both eyes
  • Problems talking or understanding speech
  • Inability to recognize or identify sensory stimuli
  • Loss of memory
  • Vertigo
  • Loss of coordination
  • Swallowing difficulties
  • Personality changes
  • Mood and emotion changes
  • Change in consciousness such as sleepiness, stupor, or lethargy
  • Loss of consciousness
  • Coma

Signs And Tests

A complete physical and neurological exam should be performed. This includes testing of all neurological functions, including vision, ability to feel sensations, movement, and mental function. The exam may reveal problems with vision, movement, sensation, reflexes, and speaking. The signs depend on how much blood flow is blocked at the time of the exam.

The doctor may hear an abnormal sound called a bruit when placing a stethoscope over the neck arteries. Blood pressure may be high. Some patients should signs of Horner's syndrome, such as drooping of one eyelid, lack of sweating on one side of the forehead, and a sunken appearance to one eye.

Tests May Include: -
  • MRI or CT of the head
  • Cerebral angiography
  • MRA or a vascular ultrasound
  • Blood tests to check for problems with connective tissue or certain genes


Stroke is a serious condition. The sooner treatment is received, the better the person will do, and the lower the chance of permanent disability or death.

Treatment depends on the severity of symptoms.

Medicine may be needed to control high blood pressure. Blood thinning drugs, such as Coumadin or aspirin, may be needed for 3 to 6 months. Surgery to repair the carotid dissection may be required. Other therapies may be needed if there are any underlying disorders of the blood vessels.

What Happens After Treatment For The Condition?

After the person is stable, treatment of the risk factors for stroke, as well as the cause of the stroke, is important to prevent further strokes. For instance, stopping smoking and controlling high blood pressure, diabetes, and high cholesterol are advised for most people.

Blood thinners such as warfarin may be discontinued in several months or a year depending upon the results of a repeat imaging test. The healthcare provider may discontinue these medications if the angiogram shows that the opening of the carotid artery is unblocked so that enough blood can flow through the artery. This is known as a patent artery and is considered to be at least 50% of normal diameter with a smooth wall.

Many people need assistance of one form or another after a stroke. This may range from using a walking cane to needing 24-hour-a-day skilled nursing care. Ongoing therapy to improve function is usually advised for at least 6 months if the person is able.

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