E-ISSN 2149-9934
Spontaneous Carotid Artery Dissection Presenting with Headache
1 Department of Emergency Medicine, Gülhane Military Medical Academy, Ankara, Turkey  
2 Department of General Surgery, Gülhane Military Medical Academy, Ankara, Turkey  
3 Department of Neurology, Gülhane Military Medical Academy, Ankara, Turkey  
4 Department of Radiology, Gülhane Military Medical Academy, Ankara, Turkey  
JEMCR 2017; 8: 20-23
DOI: 10.5152/jemcr.2016.1570
Key Words: Carotid artery, dissection, stroke

Introduction: Carotid artery dissection, an infrequent cause of transient ischemic attack and stroke among younger patients, is being increasingly diagnosed. Thromboembolic events occur following carotid artery dissection due to the narrowing of the lumen, which is a potentially life-threatening condition that can cause long-term neurological disabilities. We report a case with internal carotid artery dissection and emphasize the importance of differential diagnoses for headache and neck pain in the young and middle-aged population.


Case Report: A 33-year-old female patient was admitted to the emergency department because of headache, neck pain, speech impairment, and weakness on her right side, which persisted for five hours. She had revealed signs of confusion for the last two hours. There was no history of trauma. We received the information from her husband. The neurological examination revealed a weakness on the right upper extremity and non-fluent aphasia. She had normal results from coagulation tests. Occlusion secondary to dissection with a cervical computed tomography angiography was indicated. Low molecular weight heparin and warfarin were administered.


Conclusion: It should be kept in mind that carotid artery dissection can be asymptomatic until ischemic symptoms occur. Emergency physicians should consider carotid artery dissection in young patients who present with neck pain and headache.

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