There are a pair of arteries on either side of the neck that supply blood to the brain. It is rare for one blood vessel to break. But it is one of the most common causes of stroke in young people, according to a new report published following a study showing cases appear to be on the rise, especially among women.

The carotid arteries, collectively known as the carotid arteries, supply blood to the front of the brain, and the vertebral arteries supply blood to the back of the brain. A tear in one of these arteries (called a carotid artery dissection) can occur naturally or be caused by an injury or sudden movement of the neck. A laceration can cause a blood clot to form, which can travel to or block blood flow to the brain, causing a stroke.

One in four strokes in adults under 50 is caused by a ruptured artery in the neck, according to an American Heart Association scientific statement on carotid artery dissection published this month in the journal Stroke. The report comes days after another study in the journal Stroke showed that cases of carotid artery dissection in one Minnesota county have increased fourfold since 2002, and 12fold among women. .

However, Dr. Zafar Kesar, a neurologist and assistant professor of neurology at the Mayo Clinic School of Medicine in Rochester, says this dramatic increase is less due to an increase in the number of autopsies and more due to the increased use of non-invasive imaging to improve diagnostic ability. He said it may be due to. , Minnesota. He was the senior author of the study in the journal Stroke.

“This may be related to the increased use of CT scans in emergency situations, which has increased significantly over the past 20 years,” Keser said.

Dr. Shadi Yagi, a neurologist and associate professor and chief of the vascular neurology department at Brown University Alpert School of Medicine in Providence, Rhode Island, said medical professionals are becoming more aware of neck artery rupture. He said that it is also having an impact. Mr. Yagi chaired the committee that prepared the AHA’s scientific statement.

“People are looking for this and ordering scans if they suspect a stroke,” he said. “It’s happening more and more. I don’t see any strong reason why it’s happening more.”

The cause of non-injury dissections is unknown, but some people may be born with weak arteries and a genetic predisposition to lacerations, Yagi said. Inflammation and some infections can also make arteries more susceptible to rupturing when you jerk or suddenly twist your neck.

“It takes a perfect storm for this to happen,” he said.

The data also suggests that medical professionals are diagnosing cervical dissection in women earlier, before it causes a stroke, Keser said. He said his research on stroke found that only 28% of women with cervical dissection experienced a stroke, compared to 45% of men.

“As a community, we may be doing a better job of taking women’s symptoms more seriously than we have in the past,” Kessel said. “Maybe we’re doing a better job of eliminating bias. But that’s just my guess.”

Carotid artery dissection can be difficult to diagnose because symptoms such as severe headaches and neck pain are very common. And in some cases, autopsies are performed without any symptoms at all, Kessel said. It may only be diagnosed after a stroke occurs.

“That’s the most feared complication of an autopsy,” he says. “This is one of the most common causes of stroke in young people, which is why it’s so important to recognize the symptoms.”

For example, severe headaches can be misdiagnosed as migraines, and migraines are more common in women than men, Yagi said. “If a woman has a history of migraines and is experiencing headaches that are different from typical migraines, she should seek immediate medical attention.”

Immediate treatment is important because the risk of having a stroke is highest within the first few weeks, he said.

Treatment may include blood-thinning drugs, such as antiplatelet and anticoagulant drugs, to prevent blood clots that can cause a stroke, and pain management, if needed, to reduce headaches and neck pain. Kesel said.

The AHA report suggests individualizing treatment based on an individual’s risk of stroke and the risk of excessive bleeding that may be caused by blood-thinning drugs. We also encourage health care professionals to check for damage to arteries in other parts of the body, beyond those in the neck, after diagnosis.

“You have to look at the patient as a whole,” Yagi said. “If you have a problem here, you may have problems in other arteries as well.”