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General Medical Questions
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Q: Is it possible to hit your head and have a stroke from something called a dissection?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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February 18, 2009
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A:

Yes, a dissection can cause a stroke.

A dissection is a disruption of the layers of tissues that make up the artery wall. When a tear occurs in the innermost lining, blood can seep into the wall of the artery. Once this happens, pressure from the heart's contractions can cause blood to move through the tear. The artery wall bulges inward, making the artery channel narrow.

If the channel blocks blood flow, oxygen and nutrients can't reach cells and tissues. When an artery that supplies blood to part of the brain has a dissection, the lack of oxygen and nutrients can cause a stroke.

These arteries in our neck supply blood to the brain:

  • Two carotid arteries in the front of the neck
  • Two vertebral arteries in the back of the neck

A dissection of one of these arteries can occur spontaneously, usually if there is some underlying structural problem of the arteries. Uncommon inherited blood vessel disorders, untreated high blood pressure, smoking and diabetes can weaken arterial walls. But more often dissection of a neck artery is associated with trauma. It doesn't have to be a direct hit to the head. A major whiplash or head snap could cause the dissection.

In general, strokes occur much more often in older people. However, a stroke caused by a dissection of a carotid or vertebral artery is more likely to occur in someone younger than age 45.

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