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Carotid artery dissection presenting as exercise-induced monocular visual loss
  1. Zhilin Jiang1 and
  2. Mustafa Kadam2
  1. 1Stroke Medicine, Princess Royal University Hospital, Orpington, Kent, UK
  2. 2Stroke Medicine, Guy's and St Thomas' Hospitals NHS Trust, London, UK
  1. Correspondence to Dr Zhilin Jiang; zhilin.jiang{at}nhs.net

Abstract

A man in his 60s presented to the urgent treatment centre with isolated transient monocular visual loss in the right eye soon after completing a 5 km run. He had no preceding events, no history of neck pain and no other associated symptoms. His only medical history was presumed giant cell arteritis 3 months prior. The ophthalmology team reviewed the patient urgently and retinal artery occlusion was excluded. Carotid Doppler imaging showed a total occlusion of the right internal carotid artery. CT angiogram of the head and neck vessels revealed a dissection flap immediately proximal to the occlusion. The carotid dissection was treated with aspirin 300 mg for 2 weeks followed by clopidogrel 75 mg for a minimum of 3 months. The patient was discussed with the vascular team who confirmed that no surgical intervention would be required to treat the occlusion. With the relatively simple treatment of antiplatelet therapy, the patient is making good progress with no recurrence of symptoms.

  • Stroke
  • Neuroimaging
  • Neurology (drugs and medicines)

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Footnotes

  • Contributors Both the authors contributed equally to this paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.