A 50-year-old male presents with sudden onset of severe headache and neck pain. He was wrestling with his children when the pain started. He develops ...

Question

A 50-year-old male presents with sudden onset of severe headache and neck pain. He was wrestling with his children when the pain started. He develops progressive left-sided weakness over 30 minutes. He has a left Horner's syndrome (miosis, ptosis, anhidrosis). What is the most likely diagnosis?

Accepted Answer

Carotid artery dissection - the combination of headache, ipsilateral Horner's syndrome, and contralateral hemiparesis following neck manipulation/stress is pathognomonic

Answer

Tension-type headache with incidental weakness

Answer

Subarachnoid haemorrhage - Berry aneurysm rupture

Answer

Cervical disc prolapse causing cord compression

Answer

Vertebral artery dissection causing lateral medullary syndrome

uk-dipimc MCQ (SBA): Carotid Dissection - Classic Triad

A 50-year-old male presents with sudden onset of severe headache and neck pain. He was wrestling with his children when the pain started. He develops progressive left-sided weakness over 30 minutes. He has a left Horner's syndrome (miosis, ptosis, anhidrosis). What is the most likely diagnosis?