SPONTANEOUS BILATERAL INTERNAL CAROTID-ARTERY DISSECTION AND MIGRAINE- A POTENTIAL DIAGNOSTIC DELAY

A 36-year-old man with a history of migraine without aura, presented w ith recurrent bouts of severe headache, perception of flashing lights in both visual fields, and transient bilateral neurological deficits. In view of his history. migraine with aura was considered. Ancillary i nvestigations showed bilateral extracranial internal carotid artery di ssection. This case illustrates that when attacks of severs headache w ith scotomata and transient bilateral neurological deficits occur in a patient with a history of migraine, the diagnosis of carotid artery d issection should be considered, especially when the pattern of headach e is different or when some clinical characteristics have not been exp erienced previously.