Carotid artery dissection due to elongated styloid process

Internal carotid artery (ICA) dissection during a long-lasting telephone conversation is probably related to lateral flexion of the head.1 We observed a case in which the likely mechanism of arterial dissection in this position could be elicited; specifically, mechanical injury of the ICA due to an elongated styloid process. This mechanism of injury could have been previously underestimated in ICA dissection. Shortly following a long-lasting phone conversation (more than 1 hour), a previously healthy 43-year-old psychiatrist suddenly complained of left transient monocular blindness followed by left pulsatile tinnitus and motor aphasia. Throughout the conversation, he held the …