Image of the quarter: Dissection of the internal carotid artery causing transient ischaemic attack and Horner’s syndrome

Dissections  of  the  internal  carotid  artery  continue  to  be  one  of  the underrecognised causes of transient ischaemic attack and stroke, especially in the young. The prompt identification of the dissection as a cause of stroke or transient ischaemic attack is essential for the initiation of appropriate treatment. We report a  case  of  spontaneous  extracranial  carotid  dissection  presenting  as  a  transient ischaemic attack followed by the development of Horner’s syndrome in a 57-year-old male patient. The diagnosis was confirmed by magnetic resonance angiography. Prompt anticoagulation was initiated, and the patient remained stable and well at the end of three months.