A Case of Unilateral Vertebral Artery Dissection Progressing in a Short Time Period to Bilateral Vertebral Artery Dissection

Overview

Journal Surg Neurol Int

Specialty Neurology

Date 2019 Sep 19

PMID 31528462

Citations 3

Authors

Kiyoshi Tsuji

Akira Watanabe

Nobuhiro Nakagawa

Amami Kato

Affiliations

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Abstract

Background: Vertebral artery dissection (VAD) is an important cause of stroke in young and middle- aged people. Bilateral occurrence of VAD is generally considered rare, but the number of reports of bilateral VAD has been increasing in recent years. In this paper, we report a case of VAD on the contralateral side presenting with subarachnoid hemorrhage in the acute stage of cerebral infarction due to unilateral VAD.

Case Description: A 52-year-old man developed sudden-onset left occipital headache, dizziness, dysphagia, and right-sided hemiparesthesia and was admitted to our hospital. Head magnetic resonance imaging on admission showed a left lateral medullary infarction due to the left VAD. At this point, the right vertebral artery was normal. However, on day 9 after onset, he suddenly presented with subarachnoid hemorrhage due to the right VAD. Emergency endovascular treatment was performed for the dissecting aneurysm of the right vertebral artery. The patient's condition improved gradually after the procedure, and he was discharged with a modified Rankin Scale score of 1.

Conclusion: Bilateral occurrence of VAD may be more common than previously believed. Even in cases of unilateral VAD, we need to pay attention to the occurrence of VAD on the contralateral side.

Citing Articles

A Case of Intracranial Vertebral Artery Dissection Undetected by CT, MRI, and MRA at the Onset of Headache That Caused Subarachnoid Hemorrhage Seven Days Later.

Inoue S, Fujita A, Shinoda K, Yamashita S, Lee T, Kuroda R J Neuroendovasc Ther. 2023; 16(5):265-269.

PMID: 37502233 PMC: 10370558. DOI: 10.5797/jnet.cr.2021-0033.

Reconstructive embolization for contralateral vertebral artery dissecting aneurysm that developed after internal trapping of ruptured vertebral artery dissection: A case report and literature review.

Masuko Y, Shimizu N, Suzuki R, Suenaga J, Nagao K, Ohgaki F Surg Neurol Int. 2022; 13:124.

PMID: 35509592 PMC: 9062929. DOI: 10.25259/SNI_19_2022.

Case Report: Vertebral Artery Dissection After Intravascular Stenting of the Contralateral Unruptured Vertebral Artery Aneurysm.

You W, Feng J, Liu Q, Liu X, Lv J, Jiang Y Front Neurol. 2021; 12:599197.

PMID: 33967933 PMC: 8102744. DOI: 10.3389/fneur.2021.599197.

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