A 52-year-old man presented to the emergency department with dysphasia
and a headache after scuba diving. He was treated initially for decom
pression sickness. Subsequent workup revealed bilateral internal carot
id artery dissection. The risk factors, presenting symptoms, diagnosis
, and treatment of internal carotid artery dissection are reviewed. Th
e importance of considering unusual causes of neurologic deficits afte
r scuba diving is emphasized.