Dissection of the extracranial carotid arteries is increasingly recognized and is a common cause of stroke in young patients. In the absence of a traumatic trigger, spontaneous internal carotid artery dissection (CAD) may be related to various well defined pathological processes.1 It is likely to be multifactorial, including environmental exposures, infections, and nonspecific inflammation of the arterial wall.1 A wide spectrum of sports and different physical activities has been reported to precede spontaneous CAD.6,7 However, most frequently, the etiology remains undefined as in the present case.