title: Pain as the only manifestation of internal carotid artery dissection.
abstract: Internal carotid artery dissection is a major cause of ischemic stroke in the young. Pain is the leading symptom and is associated with other focal signs such as Horner's syndrome and painful tinnitus or with signs of cerebral or retinal ischemia. We report two patients with angiographically confirmed extracranial internal carotid artery dissection presenting with cephalic pain as the only manifestation. The first patient had a diffuse headache and a latero-cervical pain lasting for 12 days, reminiscent of carotidynia. The second patient experienced an exploding headache suggestive of subarachnoid hemorrhage, which was ruled out by computed tomography of the head and cerebrospinal fluid study. These patients demonstrate that recognition of carotid artery dissection as a cause of carotidynia and headache suggestive of subarachnoid hemorrhage may permit an earlier diagnosis and possibly the prevention of a stroke through the use of anticoagulation.
authors.affiliation: Service de Neurologie, Hôpital Saint-Antoine, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Biousse
authors.forename: F
authors.initials: F
authors.lastname: Woimant
authors.forename: P
authors.initials: P
authors.lastname: Amarenco
authors.forename: P J
authors.initials: PJ
authors.lastname: Touboul
authors.forename: M G
authors.initials: MG
authors.lastname: Bousser
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D000925:Anticoagulants / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D009333:Neck / Q000503:physiopathology*; D010146:Pain
chemical_list: D000925:Anticoagulants