How does carotid artery dissection typically present?

Carotid artery dissection is a serious condition that typically presents with a sudden onset of severe headaches and neck pain, which are key indicators of vascular disruption. The dissection occurs when there is a tear in the artery wall, leading to blood accumulating in the layers of the arterial wall. This can cause stroke symptoms shortly after the headache and neck pain, as the dissection often reduces or obstructs blood flow to the brain, potentially resulting in a stroke.

The sudden nature of the headache is often described as being different from any previous headaches a person may have experienced, often characterized as the “worst headache of my life.” Neck pain is also commonly reported, typically localized to the side of the dissection.

Transient ischemic attacks and strokes can follow as a result of the dissection, making this presentation particularly concerning. This combination of acute headache and neck pain, followed by the risk of neurological deficits due to stroke, is characteristic of carotid artery dissection, underlining the urgency of prompt medical evaluation and intervention.