PMC3806682_01
PMC3806682_02
Picture of the patient at the end of hospitalization. a Ptosis and miosis of the left eye. b A slight left-sided deviation of the tongue when protruded out of the mouth.
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PMC3806682_02_crn-0005-0155-g01.jpg
F1
Horner's syndrome, with normal direct and consensual response to the light stimulus, and no signs of either fatigability or diplopia in any direction of gaze (fig. 1a). He also presented with a dysesthesic area in the left side of the head, particularly in the parietal and frontal regions, without a clear distribution in the territory of the V cranial nerve innervation. A left-sided deviation of the tongue, when protruded, was also detected (fig. 1b).
Vascular MRI studies of the patient. a Vascular MRI performed at the beginning of the hospitalization: it clearly shows the dissection with the pseudoaneurysm of the left internal carotid vessel. b Vascular MRI performed 2 months after onset of the symptoms: the lesion of the left ICA has decreased significantly.
crn-0005-0155-g02.jpg
PMC3806682_02_crn-0005-0155-g02.jpg
F2
Otherwise, MRI revealed a dissection of the ICA in the precarotid region associated with a pseudoaneurysmatic deformation (fig. 2a). In a follow-up brain and vessel MRI 1 month later (therefore, 2 months after the beginning of the symptoms), a slight decrease of both the dissection and the pseudoaneurysmatic lesion of the left ICA could be detected (fig. 2b).