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None of the patients had signs of central retinal artery occlusion or ischemic ocular syndrome.Ischemic optic neuropathy occurred after a mean of 5.3 days(range,3-8 days)following the first symptom,which was headache in 1 patient,transient monocular blindness in 2,and hemispheric,transient ischemic attack in 1.One patient had associated Horner syndrome,and 2 had severe ipsilateral headache and orbital pain.None of the patients developed a cerebral infarction.These features differ from those observed in"classic"nonarteritic anterior ION and might therefore point to carotid dissection.Ischemic optic neuropathy may occur as an early sign of carotid dissection:young age,previous transient monocular blindness,an association with pain,Horner syndrome,or hispheric transient ischemic attacks are suggestive of this cause and should prompt confirmatory investigations. |
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