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Dr Mayer brings attention to what may be an important diagnostic observation—sudden and severe pain in the ear and at the angle of the mandible—prompting the clinician to seek angiographic evaluation of the extracranial vessels.The problem clinically concerns stabilization occurring without permanent damage. The degree of sudden occlusion varies and may increase with concomitant blood pressure elevation. Blood pressure reduction might well close the narrowed vessel completely. Surgical intervention remains curative, aside from technical errors, and should be employed.
Roome NS. Spontaneous Dissecting Aneurysm-Reply. Arch Neurol. 1977;34(8):518. doi:10.1001/archneur.1977.00500200078020
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