Another type of unusual facial pain which initially may be thought to be temporal arteritis is that caused by spontaneous dissection of the carotid and/or vertebral arteries. The vascular dissection may occur spontaneously, especially in those with unsuspected fibromuscular dysplasia. Carotid and/or vertebral artery dissection may follow head and neck injury is in "whiplash", blows to the neck, and following neck manipulation. The clues to making the diagnosis include pain over the angle of the jaw and hemicranium, oculosympathetic paresis, DYSGEUSIA (abnormal or perverted taste), and altered facial sensation.