title: Double or nothing: red flag symptoms of critical carotid stenosis, a case report.
abstract: BACKGROUND
  Detailed knowledge of every possible manifestation of Internal Carotid Artery (ICA) disease is important. For improving detection and a timely adoption of secondary prevention procedures or treatments. Transient oculomotor nerve palsies have been described associated with stenosis or occlusion of the ICA.
  
  
  METHODS
  We described a patient that develop a sequential combination of transient monocular loss of vision followed by binocular diplopia secondary to an unstable atherosclerotic preocclusive stenosis of an internal carotid artery previously treated with radiotherapy.
  
  
  CONCLUSIONS
  The peculiar sequence of transient monocular vision that give rise later into a transient binocular diplopia (double or nothing) should be kept in mind as a possible manifestation of critical stenosis of ICA.
authors.affiliation: Department of Neurology, University Hospital of Salamanca, Paseo de San Vicente 58-182, 37007, Salamanca, Spain.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Morán-Sánchez
authors.affiliation: Department of Neurology, University Hospital of Salamanca, Paseo de San Vicente 58-182, 37007, Salamanca, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Gómez-Estévez
authors.affiliation: Department of Neurology, University Hospital of Salamanca, Paseo de San Vicente 58-182, 37007, Salamanca, Spain.|Institute of Biomedical Research of Salamanca, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: Yasmina
authors.initials: Y
authors.lastname: El Berdei
authors.affiliation: Department of Neurology, University Hospital of Salamanca, Paseo de San Vicente 58-182, 37007, Salamanca, Spain.|Institute of Biomedical Research of Salamanca, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: José C
authors.initials: JC
authors.lastname: Gómez-Sánchez
authors.affiliation: Department of Neurology, University Hospital of Salamanca, Paseo de San Vicente 58-182, 37007, Salamanca, Spain. ramosmaryesther@gmail.com.|Institute of Biomedical Research of Salamanca, University Hospital of Salamanca, Salamanca, Spain. ramosmaryesther@gmail.com.
authors.forename: María E
authors.identifier: http://orcid.org/0000-0001-8557-0309
authors.initials: ME
authors.lastname: Ramos-Araque
mesh_terms: D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis*; D002343:Carotid Artery, Internal / Q000473:pathology*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014786:Vision Disorders / Q000209:etiology
keywords: Amaurosis fugax; Case report; Cervical radiotherapy; Critical carotid stenosis; Double or nothing syndrome; Ocular motor palsy