case_images: PMC3806682_01
case_images: PMC3806682_02
case_images: Picture of the patient at the end of hospitalization. a Ptosis and miosis of the left eye. b A slight left-sided deviation of the tongue when protruded out of the mouth.
case_images: crn-0005-0155-g01.jpg
case_images: PMC3806682_02_crn-0005-0155-g01.jpg
case_images: F1
case_images: Horner's syndrome, with normal direct and consensual response to the light stimulus, and no signs of either fatigability or diplopia in any direction of gaze (fig. 1a). He also presented with a dysesthesic area in the left side of the head, particularly in the parietal and frontal regions, without a clear distribution in the territory of the V cranial nerve innervation. A left-sided deviation of the tongue, when protruded, was also detected (fig. 1b).
case_images: Vascular MRI studies of the patient. a Vascular MRI performed at the beginning of the hospitalization: it clearly shows the dissection with the pseudoaneurysm of the left internal carotid vessel. b Vascular MRI performed 2 months after onset of the symptoms: the lesion of the left ICA has decreased significantly.
case_images: crn-0005-0155-g02.jpg
case_images: PMC3806682_02_crn-0005-0155-g02.jpg
case_images: F2
case_images: Otherwise, MRI revealed a dissection of the ICA in the precarotid region associated with a pseudoaneurysmatic deformation (fig. 2a). In a follow-up brain and vessel MRI 1 month later (therefore, 2 months after the beginning of the symptoms), a slight decrease of both the dissection and the pseudoaneurysmatic lesion of the left ICA could be detected (fig. 2b).