Migrainous spasm simulating carotid dissection: a pitfall in MR arteriographic findings

An MR arteriogram obtained in a patient with migraine headaches during prodrome showed features of carotid dissection. A repeated study conducted within minutes demonstrated complete patency. Vascular spasm was proposed to be the cause. Migraine occurs in more than 10% of the population. The possibility of misdiagnosing a vascular spasm as carotid dissection is real and should be guarded against since there are great prognostic and treatment implications.