{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:04:37Z","timestamp":1756339477352,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,8,15]]},"abstract":"<jats:p>Carotid artery dissection from rupture of the vasa vasorum is under-recognised. We report the case of a 60-year-old woman presenting to our hospital with a 2-week history of right-sided headache, neck pain, unequal pupils and ptosis after being hit by a wave on the beach. She was diagnosed with painful Horner\u2019s syndrome. MR angiogram revealed dissection of the right internal carotid artery with an intramural haematoma without an intimal flap. A diagnosis of carotid artery dissection from rupture of the vasa vasorum was made. Initial antithrombotic (aspirin and clexane) were stopped as she was deemed a low stroke risk with no signs of ischaemia on MR brain. Her clinical course was uneventful with resolution of the intramural haematoma seen on repeat MR angiogram.<\/jats:p>","DOI":"10.1136\/bcr-2018-225660","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T10:59:26Z","timestamp":1536749966000},"page":"bcr-2018-225660","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Hit by the wave: a case of painful Horner\u2019s and intramural haematoma of the carotid"],"prefix":"10.1136","volume":"2018","author":[{"given":"Etimbuk","family":"Umana","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Galway University Hospitals, Galway, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raazi","family":"Bajwa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Galway University Hospitals, Galway, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Radiology, Galway University Hospitals, Galway, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Acute Medical Unit (AMU), Galway University Hospital, Galway, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,9,12]]},"reference":[{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318217e71c"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318293e2eb"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.3","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000244486.30455.71"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.4","doi-asserted-by":"crossref","unstructured":"Blum CA , Yaghi S . Cervical artery dissection: a review of the epidemiology, pathophysiology, treatment, and outcome. Arch Neurosci 2015;2.doi:10.5812\/archneurosci.26670","DOI":"10.5812\/archneurosci.26670"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.5","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1212\/WNL.0000000000000381","article-title":"Clinical import of Horner syndrome in internal carotid and vertebral artery dissection","volume":"82","author":"Lyrer","year":"2014","journal-title":"Neurology"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.6","doi-asserted-by":"publisher","DOI":"10.1148\/rg.286085512"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.7","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.027615"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.8","doi-asserted-by":"publisher","DOI":"10.1097\/01.rli.0000262758.98098.d6"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.9","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/j.1552-6569.2011.00634.x","article-title":"Focal common carotid artery intramural hematoma","volume":"23","author":"Viaccoz","year":"2013","journal-title":"J Neuroimaging"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.10","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-195809000-00003"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.11","unstructured":"NICE. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management. 2018 https:\/\/www.nice.org.uk\/guidance\/CG68."},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.12","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.13","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)70018-9"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.14","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ejvs.2015.04.034","article-title":"Antithrombotic treatment for acute extracranial carotid artery dissections: a meta-analysis","volume":"50","author":"Chowdhury","year":"2015","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.15","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.617282"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.16","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12553"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.17","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181df92f7"},{"key":"2025082707353467000_2018.sep11_2.bcr-2018-225660.18","unstructured":"Liebeskind DS . Spontaneous cerebral and cervical artery dissection: treatment and prognosis. In: Post TW , ed. Waltham, MA, 2018."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225660","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:35:45Z","timestamp":1756305345000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,12]]},"references-count":18,"alternative-id":["10.1136\/bcr-2018-225660"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225660","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,9,12]]}}}