Acute internal carotid artery dissection

Discussion:

Internal carotid artery dissection is a common cause of stroke in younger patients and can be spontaneous, traumatic or iatrogenic in etiology. It can present with local pain, headache, ipsilateral Horner's syndrome (as in this case), loss of vision and ischemic stroke symptomatology.

The ICA just prior to the skull base is an important check area on non-contrast CT brain in cases of suspected dissection and Horner's syndrome.

Horner's syndrome can be caused by central, pre-ganglionic and post-ganglionic lesions. Internal carotid artery dissection represents a post-ganglionic lesion and does not classically cause anhydrosis, as opposed to central or pre-ganglionic lesions.

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