Date of download: 7/2/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Stroke in a Healthy 46-Year-Old Man JAMA. 2001;285(21): doi: /jama A, Axial T2-weighted magnetic resonance imaging (MRI) scan showingpatchy infarction in the right frontal-parietal white matter (arrow). B, Magneticresonance angiography (MRA) of the cervical vessels. On the right side ofthe figure, there is a normal left carotid artery bifurcation with the internalcarotid artery (ICA) well visualized. On the opposite side, the right commoncarotid artery and external carotid artery (ECA) are seen, but the ICA appearsoccluded (arrowhead). The 2 vessels in the center of the picture are cervicalvertebral arteries. CCA indicates common carotid artery. Figure Legend:

Date of download: 7/2/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Stroke in a Healthy 46-Year-Old Man JAMA. 2001;285(21): doi: /jama A, Cerebral angiogram showing lateral view of right common carotidartery (CCA) injection and B, delayed subtraction view. There is an abrupttapering of the internal carotid artery (ICA) distal to the bifurcation witha prolonged segment of narrowing (A, white arrowheads). On the delayed view(B), there is late filling of the distal intracranial internal carotid artery(black arrowheads), which has a more normal luminal caliber. C, Gadolinium-enhancedfollow-up magnetic resonance angiography (MRA) of the right carotid arteryin the neck. There is still residual narrowing (white arrowheads) distal tothe carotid bifurcation, but no significant stenosis. Figure Legend:

Date of download: 7/2/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Stroke in a Healthy 46-Year-Old Man JAMA. 2001;285(21): doi: /jama A, Diagram demonstrating hematoma tracking into the vessel wall,resulting in a long segment of narrowing distal to the carotid artery bifurcation.B, Pseudoaneurysmal dilatation of the carotid artery at the base of the skulldue to dissection may injure adjacent lower cranial nerves. C, T1-weightedaxial magnetic resonance imaging of the upper neck. The hematoma in the wallof the internal carotid artery appears as a bright crescent around the residualvessel lumen (appearing as a dark flow void in the center of the vessel). Figure Legend:

Date of download: 7/2/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Stroke in a Healthy 46-Year-Old Man JAMA. 2001;285(21): doi: /jama Common locations of pain and signs of Horner syndrome (ptosis, miosis)in carotid artery dissection. Figure Legend: