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A 44 year-old woman developed right neck pain after falling from a bike. Three days later, she developed the abrupt onset of a left hemiparesis.
(Left) Right Carotid Angiogram; (Right) Axial CT 3 days later. Note on the angiogram the abrupt tapering and occlusion of the internal carotid artery. This is one of the classic appearances of a dissection. On the CT scan, a large hypodensity is seen in the distribution of the right middle cerebral artery, resulting from an artery to artery embolus from the dissection.
The Electronic Curriculum is copyrighted 1998, Case Western Reserve University School of Medicine.