After minor neck trauma, a 38-year-old develops unilateral neck pain, partial Horner syndrome and transient hand weakness. Non-contrast head CT is

Question

After minor neck trauma, a 38-year-old develops unilateral neck pain, partial Horner syndrome and transient hand weakness. Non-contrast head CT is normal. What vascular study is required?

Accepted Answer

Obtain urgent arch-to-vertex CTA of the cervical and intracranial arteries for suspected dissection

Answer

Order non-contrast brain MRI alone because vessel imaging is unnecessary after symptom resolution

Answer

Use serum D-dimer to exclude dissection before exposing the patient to contrast

Answer

Obtain carotid Doppler alone because it excludes vertebral and distal internal carotid dissection

Answer

Arrange outpatient cervical radiographs because Horner syndrome localizes to a bony neck injury

Subarachnoid haemorrhage evaluation — RCPSC EM MCQ

After minor neck trauma, a 38-year-old develops unilateral neck pain, partial Horner syndrome and transient hand weakness. Non-contrast head CT is normal. What vascular study is required?