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A matter of taste
  1. T Theys1,2,
  2. K H Kho1,2,
  3. W Siemons3,
  4. V Thijs2
  1. 1
    Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
  2. 2
    Department of Neurology, University Hospitals Leuven, Leuven, Belgium
  3. 3
    Department of Radiology, University Hospitals Leuven, Leuven, Belgium
  1. Dr T Theys, Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; tom.theys{at}uz.kuleuven.be

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A 40-year-old man with a history of migraine was admitted to the emergency room with an acute unilateral left-sided headache. Neurological examination was normal, except for a left-sided Horner’s syndrome. There was no history of neck trauma. Colour duplex sonography demonstrated dissection of the left internal carotid artery. These findings were confirmed by magnetic resonance angiography.

Three days later the patient developed a bilateral ptosis with an accompanying bilateral headache. On clinical examination, bilateral Horner’s syndrome was found …

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