To the Editor.—
I wish also to reply to Dr Mayer's letter that appeared in the August issue of the Archives (34:517, 1977) concerning the article written by Dr Roome and myself entitled "Spontaneous Dissecting Aneurysm of the Internal Carotid Artery" (Arch Neurol 34:251, 1977).I have reviewed 14 previously reported cases of spontaneous dissecting aneurysm of the extracranial portion of the internal carotid artery. The clinical features were given in ten cases. Brice and Crompton1 reported the occurrence of earache and pain in the cheek, each in one instance. Lloyd and Bahnson's2 patient had roaring in the ear on the affected side. Three patients had generalized headache (Brice and Crompton,1 case 1; Bostrom and Liliequist,3 case 1; and Thapedi et al4). Patient 3 of Brice and Crompton1 had unilateral headache in addition to the earache. Headache was not mentioned in four cases (Anderson
Aberfeld DC. Spontaneous Dissecting Aneurysm. Arch Neurol. 1978;35(1):60–61. doi:10.1001/archneur.1978.00500250064020
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