Central retinal artery occlusion associated with head or neck pain revealing spontaneous internal carotid artery dissection

PURPOSE: To report two cases of head or neck pain and central retinal arter y occlusion associated with spontaneous dissection of the ipsilateral inter nal carotid artery. METHODS: Case reports. RESULTS: We describe two cases of sudden visual loss caused by central reti nal artery occlusion. Both cases were preceded by ipsilateral headaches or neck pain and tinnitus, The patient had no other neurological signs or hist ory of trauma. In both cases, cerebral angiography revealed ipsilateral int ernal carotid artery dissection. CONCLUSION: Ipsilateral headache or neck pain with tinnitus preceding centr al retinal artery occlusion is highly suggestive of internal carotid artery dissection. Early diagnosis and treatment may reduce the risk of hemispher ic stroke. (Am J Ophthalmol 2000;129:108-109. (C) 2000 by Elsevier Science Inc. All rights reserved.)