Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of unilateral neck/head pain, often described as throbbing or sharp, associated with ipsilateral Hornerโs syndrome (ptosis, miosis). History of recent minor neck trauma, chiropractic manipulation, or strenuous physical activity. Presence of focal neurological deficits including transient ischemic attack (TIA) symptoms, dysarthria, or hemiparesis.
Clinical Examination Findings
Vitals stable, though hypertension may be present. Examination of the neck reveals no pulsatile masses, but may show tenderness along the carotid artery. Auscultation may reveal a carotid bruit. Assessment for signs of connective tissue disorders (e.g., skin hyperextensibility, joint hypermobility) to rule out underlying vasculopathy.
Treatment Protocol
Immediate initiation of antithrombotic therapy (antiplatelet agents such as aspirin or clopidogrel, or anticoagulation with heparin/warfarin depending on severity and presence of thrombus). Strict blood pressure control. Monitoring for neurological deterioration. Surgical or endovascular intervention (stenting) reserved for cases with persistent hypoperfusion or recurrent ischemic events.