Hit by the wave: a case of painful Horner's and intramural haematoma of the carotid. (12th September 2018)

• Record Type: Journal Article
• Authors: Umana, Etimbuk; Bajwa, Raazi; Davidson, Ian; Gallagher, David
• Is Part Of: BMJ case reports. Volume 2018
• Publication Date: 2018-09-12
• Subjects: neuroimaging -- pain (neurology); Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-225660
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Carotid artery dissection from rupture of the vasa vasorum is under-recognised. We report the case of a 60-year-old woman presenting to our hospital with a 2-week history of right-sided headache, neck pain, unequal pupils and ptosis after being hit by a wave on the beach. She was diagnosed with painful Horner's syndrome. MR angiogram revealed dissection of the right internal carotid artery with an intramural haematoma without an intimal flap. A diagnosis of carotid artery dissection from rupture of the vasa vasorum was made. Initial antithrombotic (aspirin and clexane) were stopped as she was deemed a low stroke risk with no signs of ischaemia on MR brain. Her clinical course was uneventful with resolution of the intramural haematoma seen on repeat MR angiogram.