Spontaneous Carotid Artery Dissection Presenting as Trigeminal Neuralgia in the Emergency Department

Robert Look; Thomas J Terlau; Ryan Misek

doi:10.5811/cpcem.2020.1.44664

Spontaneous Carotid Artery Dissection Presenting as Trigeminal Neuralgia in the Emergency Department

Clin Pract Cases Emerg Med. 2020 Apr 14;4(2):255-258. doi: 10.5811/cpcem.2020.1.44664. eCollection 2020 May.

Authors

Robert Look¹, Thomas J Terlau², Ryan Misek^{1

3}

Affiliations

¹ Midwestern University, Chicago College of Osteopathic Medicine, Department of Emergency Medicine, Downers Grove, Illinois.
² Midwestern University, Chicago College of Osteopathic Medicine, Downers Grove, Illinois.
³ Midwestern University, Chicago College of Osteopathic Medicine, Department of Clinical Education, Downers Grove, Illinois.

Abstract

Introduction: Carotid artery dissection (CAD) is a critical diagnosis in the emergency department (ED). Trigeminal neuralgia, while not uncommon, may cause the patient significant discomfort but generally is not attributed to severe morbidity and mortality.

Case report: We present a case of spontaneous CAD presenting with the classic intermittent "lightning-like" jaw and head pain suggestive of trigeminal neuralgia that was ultimately diagnosed utilizing computed tomography angiogram after multiple visits to the ED.

Discussion: Coincidentally the patient had been started on anticoagulation a few days prior and no additional intervention was required.

Conclusion: This case report discusses current recommendations for diagnosis, treatment, and long-term prognosis of CAD.

Keywords: Carotid Artery Dissection; Trigeminal Neuralgia.

Publication types

Case Reports