A carotid dissection occurs when the inner lining of the carotid artery tears, allowing blood to seep between the layers of the vessel wall and create a blood-filled pocket that can narrow or block the artery’s lumen. This condition can occur spontaneously, from neck trauma, or during chiropractic manipulation, and it is an important cause of stroke in younger adults. On ultrasound, a carotid dissection may show a narrowed or occluded lumen, an intimal flap within the vessel, or a mural hematoma that appears as thickening of the vessel wall. While CT or MR angiography is usually needed for definitive diagnosis, Doppler ultrasound can detect abnormal flow patterns that raise suspicion for this condition.
Sonography Term