I’m a 45 y/o female recently diagnosed with a carotid artery dissection of the left high internal carotid artery. I was diagnosed by a MRA of the head and neck. I had no known precipitating event BUT 3 years ago, my sister had a stroke due to a carotid artery dissection of the same artery, also with no known precipitating event. I recently met with a neurosurgeon who told me to take baby aspirin daily to prevent a blood clot or stroke, to not lift anything “heavy” and that it likely will heal itself.
I explained to him that I have an active lifestyle. I love to lift and also do hot yoga, hiking, kayaking, blah blah blah and that I needed some more guidance about activity and intensity of activity that is safe to do. He was unable to offer much info other than “you could jog or ride a bike” and that it’s up to me to decide what is worth the risk.
I feel unable to decide what is “worth the risk” as the info provided was vague at best and am extremely frustrated.
Is there any data out there about activity and carotid artery dissection?
Unfortunately there is not a lot of direct evidence on this topic. Vascular dissections can happen in a variety of areas, and for a variety of reasons. Sometimes patients have an underlying connective tissue disease/abnormality like Marfan syndrome or Fibromuscular dysplasia, which I’d be a bit more suspicious of given the family history you describe. I would not expect a neurosurgeon to be comfortable evaluating for these potential conditions, so you may consider working with your primary care physician to determine which local specialists may be best for you to see.
That aside, no one is going to be able to provide you with quantitative risk data for various activities. Extrapolating from dissections in other areas (such as the coronary arteries), we find guidance like that seen here, here, and here. It’s certainly not perfect, but may be a starting point. If it were me, I would not restrict all physical activity, nor would I restrict to extremely low-level / light activity for the rest of my life either. It’s tough to give further individualized advice/guidance via the forum, as that is more in consult territory – although as I’ve mentioned, even in that context it’d be difficult to give extremely specific risk/benefit data for each activity.
Thank you very much. How do I schedule a consult?