A case of extracranial vertebral artery dissection with infarction of posterior inferior cerebellar artery

2019 ◽  
Vol 405 ◽  
pp. 12
Author(s):  
S.K. Hwang
2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Francisco Monteiro ◽  
Pedro Oliveira ◽  
Artur Condé

This paper presents a case of a perfectly healthy 36-year-old male, who went to the emergency department with a clinical picture of diffuse headache, dizziness, and asthenia with 3 days of evolution, after a long cycling race. He was admitted to the ENT Department with suspected diagnosis of peripheral vertigo. The patient developed hypoesthesia of the face, diplopia, right lateropulsion, and Romberg with preferential rightward fall, and imaging studies demonstrated an extracranial vertebral artery dissection concomitant with PICA territory infarction. This is a rare described case of a vertebral artery dissection concomitant with an infarction of the PICA territory. This case demonstrates the importance of maintaining a high degree of suspicion of stroke in patients with signs/symptoms of nystagmus/vertigo and the relevance of magnetic resonance imaging instead of tomography in the detection of these serious clinic conditions.


Author(s):  
Dr. Nosakhare I Idehen ◽  
Dr. Mohammed Awad

We present the case of a man in his thirties who had attended the emergency department with complaint of a distressing headache and associated intermittent facial droop with occasional slurred speech. The patient’s symptoms were bizarre in their nature as they were random, not sustained and he had long intervals when he was asymptomatic and was his normal self. During the course of admission his symptoms evolved resulting in neurological deficits which were more sustained, prompting the need for further imaging beyond the initial plain CT brain which showed no abnormality. This led to the diagnosis of vertebral artery dissection (VAD) complicated with an ischaemic stroke in the posterior inferior cerebellar artery distribution (PICA) on MRI/MRA. Dual anti-platelet treatment was commenced with the patient attaining gradual symptomatic improvement prior to discharge. He has reported some degree of neurological sequelae which he described as intermittent poor coordination on follow up visit in clinic after discharge.


2016 ◽  
Vol 9 (4) ◽  
pp. e9-e9
Author(s):  
Michael A Silva ◽  
Alfred P See ◽  
Priyank Khandelwal ◽  
Nirav J Patel ◽  
Mohammad Ali Aziz-Sultan

Vertebral artery dissection (VAD) is an important cause of ischemic stroke and subarachnoid hemorrhage (SAH). Dissections presenting with ischemia rarely cause SAH after more than a few hours, especially without radiographic evidence of pseudoaneurysm. We successfully treated a patient for persistent vessel injury presenting with SAH 7 years after presenting with extracranial subocclusive dissection of the right vertebral artery and an associated right posterior inferior cerebellar artery stroke. This is one of only three reported cases of delayed SAH occurring more than 2 weeks after an initial ischemic presentation of a VAD, and the only one without radiographic evidence of pseudoaneurysm at standard follow-up duration.


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