Transient migraine-like symptoms with internal carotid artery dissection

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• Internal carotid artery (ICA) dissection can present with diverse neurological symptoms.
• Migraine with aura is a common neurological condition with overlapping symptoms.
• Accurate diagnosis is critical due to distinct treatment pathways for migraine and arterial dissection.

Observation:

• Three patients with confirmed ICA dissection presented with transient symptoms mimicking migraine with aura.
• Neurological deficits evolved across different modalities before diagnosis.
• No evidence of cerebral infarction was found on clinical or radiological assessment.

Findings:

• ICA dissection can manifest as transient, aura-like neurological symptoms.
• The diagnostic challenge lies in differentiating dissection from primary migraine disorders.
• Magnetic resonance imaging (MRI) offers a non-invasive method for diagnosing ICA dissection.

Implications:

• Recognizing subtle patterns of neurological change is key for diagnosing ICA dissection in patients with migrainous symptoms.
• Timely diagnosis of ICA dissection can prevent potentially devastating complications.
• Understanding mechanisms of recurrent symptoms in ICA dissection is vital for patient management.