Clinical Practice and Cases in Emergency Medicine

Introduction: Carotid artery dissection (CAD) is a critical diagnosis in the emergency department (ED). Trigeminal neuralgia, while not uncommon, may cause the patient significant discomfort but generally is not attributed to severe morbidity and mortality.

Case Report: We present a case of spontaneous CAD presenting with the classic intermittent “lightning-like” jaw and head pain suggestive of trigeminal neuralgia that was ultimately diagnosed utilizing computed tomography angiogram after multiple visits to the ED.

Discussion: Coincidentally the patient had been started on anticoagulation a few days prior and no additional intervention was required.

Conclusion: This case report discusses current recommendations for diagnosis, treatment, and long-term prognosis of CAD.