Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 26, 2015
Petrous ICA Dissection
- Horner syndrome can be caused by multiple different etiologies. Of these, dissection of the ICA is an important consideration (as seen in the current case).
- Craniocervical artery dissection has an overall estimated incidence of 5 per 100,000. Because of the relatively fixed segment of the internal carotid artery in the carotid canal, isolated petrous segment dissection is very rare.
- Key Diagnostic Features
- Smooth narrowing of the ICA “flame sign”
- Can be assessed on CTA/MRA
- Fat-suppressed T1WI will demonstrate the false lumen with thrombus within it.
- DWI should be used to look for acute ischemia.
- DDx
- Anticoagulation therapy
- Angioplasty and stent placement for ischemia/infarction