[Internal carotid artery dissection which mimicry trigeminal neuralgia and cluster headache]

Cervical artery dissection is an acute arterial disease. Although it is not a common disease, 40-60% cerebral infarction and 20-30% transient ischemic attack could be seen. Thus, cervical artery dissection is important to recognize. Fifty-three years old female patient consulted with head, neck and face endaural pain that started after than spread directly left face half, effect of sometimes orbita and sometimes submaxillary area, occasionally accompanied by redness in the eye, extending from a few minutes to a few hours, it has been sharp and pulsatil characteristics and she never experienced before similar. Although not typical, with the initial diagnosis was trigeminal neuralgia and cluster headache (CH), carbamazepine and tramadol treatment were started. The patient who had neck pain was severe during USG, and with atypical features was BT angioed to the brain and neck concerning differential diagnosis of the patient. It was detected profile compatible with dissection at left ICA proximal. In the literature, there are rare cases of ICA dissection mimicking CH and other trigeminal autonomic cephalalgias. A common recommendation in CH case reports is the need for neurovascular imaging in cases with atypical features.