scholarly journals Minor Trauma Causing Stroke in a Young Athlete

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Vineet Gupta ◽  
Naveen Dhawan ◽  
Jaya Bahl
Keyword(s):  
Differential Diagnosis ◽  
Vertebral Artery ◽  
Treatment Modality ◽  
Vertebral Artery Dissection ◽  
Young Athlete ◽  
Left Vertebral Artery ◽  
Artery Dissection ◽  
Minor Trauma ◽  
The Third ◽  
Ct Angiogram

A 17-year-old Caucasian male presented with sudden dizziness, ataxia, vertigo, and clumsiness lasting for a couple of hours. He had a subtle trauma during a wrestling match 2 days prior to the presentation. A CT Angiogram (CTA) and MRI showed left vertebral artery dissection (VAD). The patient was treated with anticoagulation with heparin drip in the ICU. The patient was discharged home on the third day on Lovenox-warfarin bridging. This case underscores the importance of considering VAD as a differential diagnosis in patients with sports-related symptoms especially in activities entailing hyperextension or hyperrotation of neck. Due to a varied latent period, often minor underlying trauma, and subtle presentation, a low index of suspicion is warranted in timely diagnosis and treatment of VAD. Considering recent evidence in treatment modality, either antiplatelet therapy or anticoagulation may be used for treatment of VAD.

scholarly journals A Vertebral Artery Dissection with Basilar Artery Occlusion in a Child

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Katleen Devue ◽  
Annemie Van Ingelgem ◽  
Katrien De Keukeleire ◽  
Marc De Leeuw
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Vertebral Artery Dissection ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Left Vertebral Artery ◽  
Artery Dissection ◽  
Minor Trauma ◽  
Systemic Thrombolysis ◽  
The Right

This paper presents the case report of an 11-year-old boy with an acute dissection with thrombosis of the left vertebral artery and thrombosis of the basilar artery. The patient was treated with acute systemic thrombolysis, followed by intra-arterial thrombolysis, without any clinical improvement, showing left hemiplegia, bilateral clonus, hyperreflexia, and impaired consciousness. MRI indicated persistent thrombosis of the arteria basilaris with edema and ischemia of the right brainstem. Heparinization for 72 hours, followed by a two-week LMWH treatment and subsequent oral warfarin therapy, resulted in a lasting improvement of the symptoms. Vertebral artery dissection after minor trauma is rare in children. While acute basilar artery occlusion as a complication is even more infrequent, it is potentially fatal, which means that prompt diagnosis and treatment are imperative. The lack of class I recommendation guidelines for children regarding treatment of vertebral artery dissection and basilar artery occlusion means that initial and follow-up management both require a multidisciplinary approach to coordinate emergency, critical care, interventional radiology, and child neurology services.

Mild trauma causing cervical fracture through transverse foramen leading to a vertebral arteriovenous fistula

2021 ◽  
Vol 14 (6) ◽  
pp. e241735
Author(s):  
Mikkel Schou Andersen ◽  
Willy Krone ◽  
Sune Munthe
Keyword(s):  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Digital Subtraction ◽  
Trauma Mechanism ◽  
Transverse Foramen ◽  
Cervical Fractures ◽  
Vertebral Arteriovenous Fistula ◽  
Ct Angiogram

Vertebral arteriovenous fistula (vAVF) is an uncommon vascular disease defined as abnormal connections between the vertebral artery or its branches extracranially with nearby venous structures. This case report outlines the case of a man in his late 70s presenting with C1–C3 fractures after a mild trauma falling down a small staircase. CT angiogram (CTA) gave suspicion of vertebral artery dissection and pseudoaneurysm; however, digital subtraction angiography revealed a fracture-induced vAVF successfully treated endovascularly with coils. In conclusion, cervical fractures involving the transverse foramen regardless of trauma mechanism should result in a CTA. Endovascular treatment with ipsilateral vertebral artery closure is preferred due to its feasibility and safety.

scholarly journals Vertebral artery dissection: an important differential diagnosis of vertigo

2017 ◽  
Vol 83 (3) ◽  
pp. 367-369
Author(s):  
Maíra da Rocha ◽  
Bruno Higa Nakao ◽  
Evandro Maccarini Manoel ◽  
Guilherme Figner Moussalem ◽  
Fernando Freitas Ganança
Keyword(s):  
Differential Diagnosis ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Important Differential Diagnosis

scholarly journals Left vertebral artery dissection causing bilateral internuclear ophthalmoplegia

CJEM ◽  
2008 ◽  
Vol 10 (05) ◽  
pp. 485-487
Author(s):  
Glen Jickling ◽  
Kelvin Leung ◽  
Kenman Gan ◽  
Ashfaq Shuaib ◽  
James Lewis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Clinical Findings ◽  
Left Vertebral Artery ◽  
Artery Dissection ◽  
Internuclear Ophthalmoplegia ◽  
Gradual Improvement ◽  
Brainstem Lesion ◽  
Posterior Neck

ABSTRACT A 21-year-old woman presented to the emergency department 1 day after a fall. On the day of presentation, she awoke with horizontal diplopia and posterior neck pain. Based on clinical findings, she was diagnosed with bilateral internuclear ophthalmoplegia. A conventional angiogram identified a left vertebral artery dissection. She was started on anticoagulant therapy, with gradual improvement of her diplopia over several months. Diplopia is frequently seen in the emergency department. Internuclear ophthalmoplegia is a cause of binocular diplopia and is important to recognize because it indicates a brainstem lesion requiring neurologic evaluation.

scholarly journals Combined reconstructive and deconstructive endovascular approach for bilateral vertebral artery dissection with subarachnoid hemorrhage

2019 ◽  
Vol 46 (Suppl_1) ◽  
pp. V13
Author(s):  
Jacob Cherian ◽  
Thomas P. Madaelil ◽  
Frank Tong ◽  
Brian M. Howard ◽  
C. Michael Cawley ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Left Vertebral Artery ◽  
Artery Dissection ◽  
Critical Flow ◽  
Alternative Strategies ◽  
Potential Alternative ◽  
Endovascular Approach ◽  
The Right

The video highlights a challenging case of bilateral vertebral artery dissection presenting with subarachnoid hemorrhage. The patient was found to have a critical flow-limiting stenosis in his dominant right vertebral artery and a ruptured pseudoaneurysm in his left vertebral artery. A single-stage endovascular treatment with stent reconstruction of the right vertebral artery and coil embolization sacrifice of the left side was performed. The case highlights the rationale for treatment and potential alternative strategies.The video can be found here: https://youtu.be/e0U_JE2jISw.

scholarly journals Traumatic Vertebral Artery Dissection and Basilar Artery Occlusion/Stroke in a 7-Year-Old Child: A Case Report

2019 ◽  
Vol 08 (04) ◽  
pp. 233-237
Author(s):  
Binh Phung ◽  
Trusha Shah
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Basilar Artery ◽  
Vertebral Artery Dissection ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Left Vertebral Artery ◽  
Artery Dissection ◽  
Life Threatening ◽  
Computed Tomography Angiogram

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.

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

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.

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

2019 ◽  
Vol 59 (4) ◽  
pp. 154-161 ◽  
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

Spinal Cord Ischemia due to Vertebral Artery Dissection

2005 ◽  
Vol 18 (3) ◽  
pp. 390-394
Author(s):  
M. Bergui ◽  
G. Ventilii ◽  
F.M. Ferrio ◽  
D.R. Daniele ◽  
G.B. Bradač
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Vertebral Artery ◽  
Grey Matter ◽  
Spinal Cord Ischemia ◽  
Vertebral Artery Dissection ◽  
Cervical Cord ◽  
Artery Dissection ◽  
Spinal Cord Infarction ◽  
Central Regions

We reviewed clinical and neuroradiological findings in 37 consecutive patients with cervical cord infarction due to vertebral artery dissection diagnosed at our institution from 1996 to 2004. Four patients had clinical and neuroradiological findings consistent with spinal cord ischemia. Three patients had “pencil-like” infarction at C3-C5 level; one patient had an infarction of the anterior horns of the spinal grey matter at C3-C4 level. Symptoms were crural sensory deficit with mild tetraparesis and proximal strength deficit of the arms, respectively. Spinal cord infarction complicated vertebral artery dissection in about 10% of patients of our series. Infarctions involved the most central regions of the spinal cord, with relative sparing of the peripheral white matter tracts. Clinical and MRI pictures were almost typical, and consistent with a hemodynamic mechanism for the lesions. Vertebral artery dissection must be considered in the differential diagnosis in patients with cervical cord infarction.

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