Abstract： To the Editor:Internal carotid artery dissection (ICAD) is one of the main causes of stroke in young-and middle-aged adults with a current mortality rate of 40％.Delayed diagnosis and treatment can result in permanent neurological impairment and/or death.[1] Currently,digital subtraction angiography (DSA) is considered the gold standard for diagnosis while conventional ultrasound (US) is utilized as a screening tool.The sonographic features of ICAD include a luminal flap,stenosis,or occlusion secondary to the presence ofhematoma and/or thrombus.These characteristics may be subtle,which diminishes US sensitivity for detecting ICAD.The following case report exemplifies US ability to diagnose ICAD through the demonstration of an unusual curve and the detection of an intraluminal hematoma.