Spontaneous Vertebral Artery Dissection
Take Home Message:
- Vertebral artery dissection (VAD) has been associated with fast neck movements including cervical manipulation (CM)
- Recent research has called into question any role cervical manipulation may play with regard to causing VAD
- This article demonstrates a fully spontaneous VAD without exposure to cervical manipulation, sports trauma or fast neck movements.
- This article adds to the literature that calls into question any relationship between CM and VAD.
The article represents a case of a young patient with atypical clinical and paraclinical presentation of vertebral artery dissection by multiple cerebral infarcts, localized at the supratentorial and infratentorial levels in the posterior circulation. A case of a 21-year-old man, without a history of trauma in the cervical area or at the cranial level, without recent chiropractic maneuvers or practicing a sport, which required rapid, extreme, rotational movements of the neck, was examined. He presented to the emergency room with nausea, numbness of the left limbs, dysarthria, and incoordination of walking, with multiple objective signs at the neurological examination, which revealed right vertebral artery subacute dissection after the paraclinical investigations. The case was particular due to the atypical debut symptomatology, through the installation of the clinical picture in stages, during 4 hours and by multiple infarcts through the artery-to-artery embolic mechanism in the posterior cerebral territory.
Cristea I, Popa C. Spontaneous vertebral artery dissection with multiple supratentorial and infratentorial acute infarcts in the posterior circulation Case report. J Med Life. 2016 Jul-Sep;9(3):294-296