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Background
Periodontal infections might represent one of the causative factors for cervical artery dissection (CAD).
Case presentation
A 49-year-old Caucasian woman, a former smoker, was admitted on 3 October 2014, due to headache. The patient had been suffering from a right second inferior molar infection with a cervical phlegmon for 1 week prior to admission. On 2 October 2014, the patient went to the dentist and a molar extraction was performed in the morning. The procedure was performed under local anaesthesia and required a cervical hyperextension for only a few minutes. No direct trauma related to the dentist's instruments was reported. In the afternoon, the patient began to experience right hemifacial pain that progressed towards an intense and bilateral headache. Analgesic treatment was not effective and the headache prevented sleep. The patient reported nausea and vomiting, photophobia and decreased right eye vision. Neurological status at the time of admission revealed right miosis, ptosis and conjuntival hyperaemia. The rest of her neurological status was normal.
Investigations
Cranial CT scan was normal. A lumbar puncture excluded central nervous system...