Abstract：
OBJECTIVE:To describe management challenges and follow-up data for three years in a case with spontaneous carotid artery dissection (SCAD). CASE REPORT:We present a case of SCAD that presented with Horner's syndrome and headache. The patient developed the SCAD, Horner's syndrome and headache one month after a lumbar epidural steroid injection for radicular pain. Three years follow-up experience with therapeutic challenges is described. CONCLUSION:A life threatening cause of headache is described which occurred one month after receiving an uneventful lumbar epidural steroid injection. Despite no carotid arterial luminal flow restriction and anticoagulation, the headache and Horner's syndrome persisted for three years. Stellate ganglion blocks were able to relieve both neck pain and headache temporarily. In patients with new onset headache and Horner's syndrome SCAD must be ruled out. If SCAD is detected, appropriate therapy including anticoagulation must be instituted immediately, since the potential for continued dissection or embolization remain significant.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Datta S,Candido KDsubject
Has Abstractpub_date
2004-10-01 00:00:00pages
483-5issue
4eissn
1533-3159issn
2150-1149journal_volume
7pub_type
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