Image of the Week: Angiogram reveals life-threatening diagnosis

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A 48-year-old man with a previous history of occasional headache, blurry vision, and periods of brief blindness lost consciousness, fell, and suffered minor head trauma. Afterward, he presented with aphasia, right hemiparesis, mydriasis in the right eye, and ptosis and myosis on the left eye.


This patient has a left-sided carotid artery dissection. The combination of headache with ptosis and myosis should always prompt consideration of this type of dissection. Therapy commonly includes antiplatelet agents or anticoagulation.


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