A 14 year-old male with intracranial carotid artery dissection had transient neurologic symptoms and no antecedent illness or trauma, as reported from the University of Kentucky. Lexington. Diagnosis made by dynamic CT was confirmed by catheter arteriography. The dissection involved the supraclinoid segment of the left internal carotid. Vasculitis, prothrombotic states, and collagen defects were excluded as possible causes. 
COMMENT. Occlusion of the supraclinoid segment of the internal carotid artery is a common arteriographic finding in children with acute hemiplegia. Associated disorders include pre-existing heart disease, trauma, CNS infection, sickle cell disease, and moyamoya disease, but a high proportion are idiopathic.
Traumatic vertebral artery dissection may present with vomiting, occipital headache, stiff neck, and ataxia. A review of 19 published cases found 1 died, 2 had residual quadriplegia, 9 had mild to moderate hemiparesis, ataxia, and/or dysarthria, and 7 (37%) recovered (Ped Neur Briefs Jan 1994).