Carotid artery dissection

Carotid artery dissection (CAD) is one of the more common causes of stroke in persons younger than 50 years. In this age group and in older persons, CAD is most often associated with trauma. Significant morbidity can be a consequence of CAD, particularly a stroke or other permanent neurologic deficit. Because stroke is the third leading cause of death in the United States, attention has focused in the past decade on understanding the phenomenon of dissection of the carotid artery. This article presents a review of the risk factors associated with CAD, the role of the nurse as a provider of care for these persons, and the approaches to prevent or limit disability related to CAD, the ultimate goal of patient care. Nurses play a crucial role in the detection of CAD and in the prevention of strokes or other neurologic disabilities through recognition of persons at risk, assessment for early signs and symptoms, and implementation of prophylactic measures. Because more than half of persons with CAD have cerebral ischemia, thrombolytic, anticoagulant, and antiplatelet regimens have evolved to limit the development of a thromboembolic event associated with dissection. The administration of these agents, the monitoring for their effectiveness, and the education of patients receiving them are fundamental aspects of care.