title: Head pain in non-traumatic carotid artery dissection: a series of 65 patients.
abstract: In order to assess the prevalence and characteristics of cephalic pain in internal carotid artery (ICA) dissection, and to compare clinical and angiographic features of patients with painful and non-painful dissections, we observed 65 patients with angiographically diagnosed extracranial ICA dissection from 1972 to 1990. Forty-eight patients (74%) complained of a cephalic pain which was inaugural in 38 (58.5%). It was homolateral to the dissection in 79% of cases and lasted from 1 h to 30 days, with a median of 5 days. Signs of cerebral or retinal ischemia were observed in 79% of patients, often delayed and occurring up to 29 days after the onset of pain. A painful Horner's syndrome was present in 31% of patients, and was the only manifestation of dissection in 16%. The clinical presentation of the dissections and angiographic findings were similar in patients with and without pain except for a past history of migraine which was more frequent in patients with painful dissections. Cephalic pain is frequent and often inaugural in carotid dissection. Its recognition is important for early diagnosis and treatment.
authors.affiliation: Service de neurologie, hôpital Saint-Antoine, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Biousse
authors.forename: J
authors.initials: J
authors.lastname: D'Anglejan-Chatillon
authors.forename: H
authors.initials: H
authors.lastname: Massiou
authors.forename: M G
authors.initials: MG
authors.lastname: Bousser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000209:etiology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D003276:Contraceptives, Oral / Q000009:adverse effects; D003937:Diagnosis, Differential; D005157:Facial Pain / Q000209:etiology; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications; D006261:Headache / Q000000981:diagnostic imaging / Q000209:etiology*; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis; D009325:Nausea / Q000209:etiology; D009333:Neck; D010146:Pain / Q000209:etiology; D012171:Retinal Vessels; D014012:Tinnitus / Q000209:etiology; D014711:Vertebral Artery / Q000000981:diagnostic imaging
chemical_list: D003276:Contraceptives, Oral