Oculosympathetic paresis and hemicrania in spontaneous dissection of the internal carotid artery: Four cases and review of the literature

Abstract

This report describes four patients who developed oculosympathetic paresis and hemicrania due to spontaneous internal carotid artery dissection. This diagnosis was established with non-invasive techniques in three of the four patients. None of the patients developed cerebrovascular complications and the long-term outcomes were excellent, irrespective of treatment with antiplatelet agents or anticoagulation. The epidemiology, clinical aspects, pathogenesis, diagnosis, and management of non-traumatic, internal carotid dissections are reviewed. Presentation with hemicrania and ipsilateral Horner's syndrome indicates a favorable prognosis for patients with spontaneous internal carotid artery dissections.

Key Words:

• Horner's syndrome
• dissection
• stroke
• hemicrania