jmj11 Posted November 29, 2018 Share Posted November 29, 2018 44 YO female has a sudden onset of left neck and jaw pain. Her husband notices that she starts to slurs some of her words. He rushes her to the ER. She had a CT and set up a brain MRI for early morning. Symptoms evolve to mostly left orbit pain. The MRI is normal. Rounded by a neurologist for 2-3 minutes. Told her she didn't have a stroke and to go home. The left orbit pain continues as does a Horner's syndrome (starting, they think, during the night at the hospital, prior to the neurologist's visit) and has persisted for the week. The pain is still focused in her left eye (8/10) and is a tearing sensation. Her husband brings her to our headache clinic. BTW, she feels a lessor pain still in her neck and left shoulder. What would do you think this is? (I have the answer but just wanted to know what you thought). Link to comment Share on other sites More sharing options...
karebear12892 Posted November 29, 2018 Share Posted November 29, 2018 carotid artery dissection Link to comment Share on other sites More sharing options...
jmj11 Posted November 29, 2018 Author Share Posted November 29, 2018 10 minutes ago, karebear12892 said: carotid artery dissection Bingo. That was easy wasn't it? I don't know why it was missed by the neurologist. Link to comment Share on other sites More sharing options...
medic25 Posted November 30, 2018 Share Posted November 30, 2018 Dry CT head? We have moved to CTA head/neck as standard initial imaging for possible stroke patients. Link to comment Share on other sites More sharing options...
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