Comments by Drs Vijayan and Watson are appreciatively received. The purpose of our report was to draw attention to the fact that hemicrania and oculosympathetic palsy constitute a rather common mode of manifestation of spontaneous dissection of the internal carotid artery. This is not the only mode of presentation of this entity and was noted only in five of 13 cases seen by us during a two-year period. Furthermore, this combination of symptoms and signs is seen in a number of other pathological processes involving the internal carotid artery. Examples have been mentioned in the letter by Drs Vijayan and Watson, as well as in our report.Oculosympathetic palsy, different from Horner's syndrome by absence of facial anhidrosis together with evidences of trigeminal nerve involvement, were the essential components of Raeder's paratrigeminal syndrome. In one of the five patients described by Raeder, merely "neuralgic pains" in the distribution
Mokri B. Spontaneous Internal Carotid Ariery Dissection and Abnormal Facial Sweating-Reply. Arch Neurol. 1980;37(7):468–469. doi:10.1001/archneur.1980.00500560098026
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