Arterial Dissection in Children

What is an arterial dissection?

An arterial dissection is a tear along the inside lining of an artery and can occur in a child's head, neck or spine. It can cause serious neurologic problems, such as stroke. It may be referred to as a vertebral dissection (involving arteries supplying blood to the brainstem and upper spinal cord) or a carotid dissection (involving arteries feeding the hemispheres of the brain, as well as the head and neck). In one type of arterial dissection, called a dissecting pseudoaneurysm, the tear in the artery wall can enlarge to form a small pouch in which blood collects, known as a false lumen.

With proper treatment, many children recover completely from arterial dissection. However, some children may be left with deficits in brain function that can range from mild to severe. Children with conditions that predispose them to arterial dissection may be advised to permanently avoid rough contact sports or high-risk activities that could stress the vessels.

How we care for arterial dissection

Neck or cranial arterial dissection is most often found after a child has had a stroke that is related to its occurrence. Children who have experienced a stroke as the result of an arterial dissection receive treatment from the team of experts in our Stroke and Cerebrovascular Center. Both the stroke and the arterial dissection are usually diagnosed by careful examination and MRI. Commonly, a child with neck or brain dissection, especially if accompanied by stroke, is treated with anticoagulation.

The Cerebrovascular Surgery and Interventions Center at Boston Children's Hospital offers a number of different treatments for arterial dissection, based on your child's needs and the results of careful and detailed imaging. Because we see many children with arterial dissection, we are able to track the efficacy of specific treatments over time and use this information to guide our practice.