Internal carotid artery dissection is one of the most frequent causes of stroke in young people. Seventy percents of cases are under 50 years old and there is a slight predominance of males. Trivial head injury or neck trauma may cause dissection. Magnetic resonance angiography is important in diagnosis and management planning. Early anti-thrombotic therapy is the main treatment modality. In this case report, a 27 years old male van driver who has played boxing for several years presented to us with acute confusion after a car accident. The patient was put on warfarin for several months and enjoyed good recovery at follow up.

We aimed to develop a questionnaire with psychometric evidence of reliability and validity to evaluate patient satisfaction with a Fast Track Protocol Driven Service, which was developed to shorten the waiting time and improve the outcome of selected groups of patients. Such patients were initially managed by well-trained nurses according to defined protocols and backed up by experienced medical practitioners. We would like to evaluate their satisfaction because traditionally patients used to be managed by doctors. Methods: We collected data from 199 subjects from July 2014 to February 2015 using a questionnaire consisting of 24 questions. The subjects were given the questionnaire after receiving treatment and they filled in the questionnaire on sole voluntary basis. These 24 items were subject to Principal Component Analysis. The number of components to be extracted depended on the Eigenvalue. We utilised Varimax rotation for further interpretation and determined which question belonged to which component. We then assessed the internal consistency of each component by calculating Cronbach's alpha. Finally we calculated the mean score for each subscale. Results: Three components were extracted with good internal consistency, namely "Clinical care", "Negligence" and "Comprehensiveness". The mean score for the above components was 43.15, 11.27 and 9.62 respectively. They proved good patient satisfaction in all three aspects. Conclusions: We have developed a questionnaire with reliability and validity for evaluation of patient satisfaction with our service. The data of our survey shows that our patients are satisfied in the three aspects namely "Clinical care", "Negligence" and "Comprehensiveness" statistically.