Poster 531 Left Vertebral Artery Dissection Resulting in Multiple Cerebellar, Occipital, and Thalamic Cerebrovascular Accidents (CVAs) in a 38-Year-Old Man With a History of Chronic Self-Neck Manipulation: A Case Report

AbstractVertebral artery dissection (VAD) followed by basilar artery occlusion/stroke (BAO/BAS) is a rare but potentially life-threatening complication. We present a case report of a 7-year-old boy with VAD complicated by BAO/BAS 4 days after falling off a scooter. Symptoms included left-sided weakness and facial droop preceded by a 20-minute episode of altered sensorium. Magnetic resonance imaging showed ischemic changes in the left posterior inferior cerebellum and right pons. Computed tomography angiogram confirmed dissection of the left vertebral artery with occlusion/thrombosis of the basilar artery. Heparinization for 96 hours, followed by 6 months of low-molecular weight heparin injection, resulted in improvement of his neurological symptoms.

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Right Vertebral Artery Transection With a Vertical Distraction of C5-6: Case Report of a Patient Survival

The American Surgeon ◽

10.1177/0003134820919725 ◽

2020 ◽

Vol 86 (5) ◽

pp. 531-533

Author(s):

Jared Griffard ◽

Reagan Bollig

Keyword(s):

Spinal Cord ◽

Case Report ◽

Vertebral Artery ◽

Spinal Cord Injuries ◽

Patient Survival ◽

Multidisciplinary Treatment ◽

Vertebral Artery Dissection ◽

Spinal Column ◽

Left Vertebral Artery ◽

Artery Dissection

Spinal column injuries are very commonly diagnosed in the multitrauma population, and extensive distraction injuries are often fatal due to cerebrovascular injuries or spinal cord injuries. We present a 62-year-old female who presented after an MVC with a 2-cm vertical distraction injury of C5-6 with a right vertebral artery transection and left vertebral artery dissection. She received multidisciplinary treatment which resulted in her survival, albeit with severe neurologic deficits. We challenge the current literature that suggests a blunt vertebral artery transection is 100% fatal.

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Bilateral Internal Carotid and Left Vertebral Artery Dissection after Blunt Trauma: A Case Report and Literature Review

Neurologia medico-chirurgica ◽

10.2176/nmc.cr.2018-0239 ◽

2019 ◽

Vol 59 (4) ◽

pp. 154-161 ◽

Cited By ~ 1

Author(s):

Kenichi ARIYADA ◽

Keita SHIBAHASHI ◽

Hidenori HODA ◽

Shinta WATANABE ◽

Masahiro NISHIDA ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Vertebral Artery ◽

Blunt Trauma ◽

Internal Carotid ◽

Vertebral Artery Dissection ◽

Left Vertebral Artery ◽

Artery Dissection

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Simultaneous spontaneous arterial dissections in a 38-year-old woman presenting during the covid-19 pandemic: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab035 ◽

2021 ◽

Vol 5 (3) ◽

Author(s):

Lynsey Hewitson ◽

Chih Wong ◽

Shahid Aziz ◽

Amardeep Dastidar

Keyword(s):

Case Report ◽

Vertebral Artery ◽

Invasive Coronary Angiography ◽

Vertebral Artery Dissection ◽

High Sensitivity ◽

Left Vertebral Artery ◽

Artery Dissection ◽

Minimal Risk ◽

Coronary Artery Dissection ◽

First Case

Abstract Background Spontaneous coronary artery dissection (SCAD) is an increasingly recognized and important cause of acute myocardial infarction, particularly in women under 50, often with minimal risk factors. Many patients have underlying arteriopathy, most commonly in the form of fibromuscular dysplasia. Case summary A 38-year-old woman presented to the hospital with chest pain and elevated high-sensitivity Troponin. Invasive coronary angiography demonstrated SCAD of the left anterior descending artery. The same day the patient developed a severe progressive headache and subsequent imaging revealed a left vertebral artery dissection. She was managed conservatively with optimal medical therapy and was successfully discharged from hospital on Day 7. Discussion To our knowledge, this is the first case report of simultaneous spontaneous coronary and vertebral artery dissections not related to pregnancy. It highlights not only the importance of recognizing and accurately diagnosing SCAD, but also of appreciating the possibility of underlying arteriopathy: this is paramount to ensuring appropriate investigations, follow-up and assessment of any unexplained symptoms in this patient group.

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Atraumatic Vertebral Artery Dissection in a Patient With a Migraine Headache

Military Medicine ◽

10.1093/milmed/usab135 ◽

2021 ◽

Author(s):

Michael L Lloyd ◽

Samuel Billingslea ◽

Richard Slama

Keyword(s):

Emergency Department ◽

Vertebral Artery ◽

Vertebral Artery Dissection ◽

Left Vertebral Artery ◽

Artery Dissection ◽

Intravenous Contrast ◽

Lingual Gyrus ◽

History Of ◽

High Index Of Suspicion ◽

Persistent Headache

ABSTRACT This case discusses a 34-year-old active duty male who presented to the emergency department with a 2-week persistent headache. His initial review of symptoms was reassuring until a detailed neurologic examination on his second visit revealed a visual deficit in the left upper quadrant. Additionally, he complained of intermittent tension headaches for the last several years but had no history of diagnosed migraines until he was seen 4 days prior for empiric migraine therapy in the same emergency department and left without improvement in symptoms. On his return visit, computerized tomography scan with intravenous contrast revealed a left vertebral artery dissection and hematoma. The patient was admitted for medical management and subsequently found to have suffered a small infarction of right lingual gyrus cortex on magnetic resonance imaging. This case illustrates the importance of maintaining a broad differential diagnosis and high index of suspicion in the patient with new focal neurologic findings in order to diagnose a potentially fatal disease.

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P.105 Missed vertebral artery dissection: a case series

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.207 ◽

2018 ◽

Vol 45 (s2) ◽

pp. S44-S44

Author(s):

A Persad ◽

B Stewart

Keyword(s):

Vertebral Artery ◽

Vertebral Artery Dissection ◽

Case Series ◽

Posterior Circulation ◽

Artery Dissection ◽

Minor Trauma ◽

Posterior Circulation Stroke ◽

Acute Infarction ◽

History Of ◽

Neck Manipulation

Background: Vertebral artery dissections are the second most common cause of posterior circulation stroke. Particularly in young people, they must be considered as causes of acute infarction, especially with a history of cervical trauma. Here, we present three cases of vertebral artery dissection that were initially not diagnosed as such. All were caused by uncommon mechanisms; one by self-inflicted neck manipulation, and one as a sequela of falling from a trampoline, and one from minor trauma to the head while standing. Methods: This is a series of three cases seen by the authors of posterior circulation stroke secondary to vertebral artery dissection caused by uncommon mechanisms. Results: N/A Conclusions: Vertebral artery dissection should be considered as a differential diagnosis in patients presenting with acute head and/or neck pain and any neurological findings in relation to acute neck trauma.

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