Dissection of the internal carotid artery causing transient ischaemic attack and Horner's syndrome

Dissections of the internal carotid artery continue to be one of the underrecognised causes of transient ischaemic attack and stroke, especially in the young. The prompt identification of the dissection as a cause of stroke or transient ischaemic attack is essential for the initiation of appropriate treatment. We report a case of spontaneous extracranial carotid dissection presenting as a transient ischaemic attack followed by the development of Horner's syndrome in a 57-year old male patient. The diagnosis was confirmed by magnetic resonance angiography. Prompt anticoagulation was initiated, and the patient remained stable and well at the end of three months.