transient ischaemic attack

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.

This symposium covered a wide range of conditions of interest to the geriatrician, the general physician and the general practitioner, including demographic shift, the epidemiology of ageing, diabetes in older people, investigation and management of falls, an update on stroke (including the role of neurovascular clinics, stroke thrombolysis and rehabilitation) and the management of coronary heart disease in the elderly.

We report an unusual case of calcification of mitral valve annulus imaged with multiple non-invasive modalities in a patient who suffered a transient ischaemic attack, probably from thrombus overlying the mitral annular calcification. Both this mode of presentation and the imaging features of the annular calcification were relatively unusual, and the images obtained are remarkably clear and diagnostic.

Keywords Anticoagulation, caseous mitral annular calcification, embolism, multimodality imaging, stroke, transient ischaemic attack