Spontaneous Bilateral Internal Carotid Artery Dissections in a Young Female with Headache

Spontaneous cervical artery dissection (sCAD) occurs when the intimal lining separates from the outer wall of the artery. Although rare, it is a common cause of stroke in young people. Presentations range from isolated headache to severe stroke symptoms. A 41-year-old woman with minimal past medical history presented with left-sided headache and transient right leg weakness and numbness. The patient underwent computed tomography (CT) angiography of the neck that showed bilateral internal carotid artery dissections with a relative stenosis from pseudoaneurysm formation on the left. She was placed on a heparin drip and transitioned to warfarin but subsequently required stent placement 10 days later. If this patient had not undergone CT angiography at the time of presentation, she might have suffered significant morbidity and possible mortality.