Kareem Abed, Amit Misra and Viren Vankawala
This case describes a patient with amaurosis fugax as a result of non-traumatic internal carotid dissection. Typical symptoms of monocular blindness, especially in the setting of headache or neck pain should prompt evaluation for carotid dissection. Initial presentation with transient vision loss, lasting thirty minutes with a normal ophthalmic exam should raise suspicion for transient ischemic attack as well as carotid dissection. Symptoms may progress with resultant cerebral infarction as the dissection progresses. Carotid ultrasound with notable decreased internal carotid artery velocity prompts CT angiography of the neck confirming the carotid dissection. Anti-platelet therapy is the first line treatment, with anticoagulation reserved for cases of recurrent, progressive symptomatic episodes.
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