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Carotid artery dissection — ABEM Board MCQ

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HardNeurological emergenciesCarotid artery dissectionABEM Board

A 34-year-old woman arrives as ESI 2 with severe unilateral headache, ptosis, miosis, and anhidrosis after neck manipulation. She has transient left arm weakness. BP is 142/86. Which of the following is the most appropriate imaging study?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — CT angiography of the head and neck

Painful Horner syndrome with transient neurologic symptoms after neck manipulation suggests carotid artery dissection; CTA head and neck is appropriate.

Reference: AHA/ASA cervical artery dissection guidance; ACEP neurologic emergency resources