Bilateral Vertebral Artery Dissection: A Case Report with Literature Review.
Journal
Case reports in medicine
ISSN: 1687-9627
Titre abrégé: Case Rep Med
Pays: United States
ID NLM: 101512910
Informations de publication
Date de publication:
2020
2020
Historique:
received:
06
10
2019
revised:
24
03
2020
accepted:
13
04
2020
entrez:
26
10
2020
pubmed:
27
10
2020
medline:
27
10
2020
Statut:
epublish
Résumé
Vertebral artery dissection (VAD) is a rare cause of ischemic stroke in young patients. The largely nonspecific symptoms and delayed presentation pose a serious diagnostic challenge. Medical management with either anticoagulation or antiplatelet therapy is recommended, but there are no reports of successful dual therapy. We report a case of spontaneous bilateral vertebral artery dissections (VADs) treated with both anticoagulation and antiplatelet therapy and a literature review on clinical presentation and the current medical and surgical management options. A 37-year-old healthy female presented to the emergency department with worsening neck pain and headache for two weeks despite over-the-counter medication, block therapy, yoga, and deep tissue neck massage. She denied any trauma but admitted to multiple roller coaster rides over the past few months. CT angiography was concerning for VADs, and MRI brain revealed multiple strokes in the left posterior inferior cerebellar artery (PICA) territory. Cerebral arteriography confirmed the diagnosis of VADs. The patient was initiated on warfarin, along with atorvastatin and aspirin. She was discharged home with no complications and followed up with neurology as an outpatient. MR angiography after three months revealed complete resolution of the dissection. The patient did not report any bleeding complications from dual therapy.
Identifiants
pubmed: 33101417
doi: 10.1155/2020/8180926
pmc: PMC7568148
doi:
Types de publication
Case Reports
Langues
eng
Pagination
8180926Informations de copyright
Copyright © 2020 Olga Gomez‐Rojas et al.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest in preparing this article.
Références
J Headache Pain. 2015 Dec;16(Suppl 1):A129
pubmed: 28132259
J Spinal Cord Med. 2014 Mar;37(2):233-6
pubmed: 24090478
Neurosurg Rev. 2014 Oct;37(4):569-77
pubmed: 24715276
J Neurol Neurosurg Psychiatry. 1991 Oct;54(10):863-9
pubmed: 1744639
Ann Indian Acad Neurol. 2020 Jan-Feb;23(1):129-130
pubmed: 32055137
Lancet Neurol. 2009 Jul;8(7):668-78
pubmed: 19539238
Int J Stroke. 2015 Oct;10 Suppl A100:30-3
pubmed: 26120954
J Emerg Trauma Shock. 2014 Jan;7(1):47-8
pubmed: 24550631
Stroke. 2019 Dec;50(12):e344-e418
pubmed: 31662037
J Hand Surg Am. 1985 Jul;10(4):451-6
pubmed: 3160760
Circulation. 2011 Jul 26;124(4):489-532
pubmed: 21282505
Interv Neuroradiol. 2006 Mar 15;12(1):73-8
pubmed: 20569557
J Stroke Cerebrovasc Dis. 2008 Jan-Feb;17(1):39-41
pubmed: 18190821
Neurosurgery. 2011 Apr;68(4):856-66; discussion 866
pubmed: 21242839
J Clin Neurol. 2018 Jul;14(3):428-429
pubmed: 29971986
Clin Neuroradiol. 2010 Dec;20(4):255-9
pubmed: 20959946
Eur J Vasc Endovasc Surg. 2005 Apr;29(4):350-2
pubmed: 15749034
Neurol Neurochir Pol. 2014;48(4):299-304
pubmed: 25168332
Postepy Kardiol Interwencyjnej. 2019;15(3):321-327
pubmed: 31592256
J Neurol. 1987 May;234(4):237-40
pubmed: 3612194
Intern Med. 2007;46(17):1467-70
pubmed: 17827851
Biomed Res Int. 2017;2017:3072098
pubmed: 28607929
Can J Neurol Sci. 1989 Aug;16(3):348-51
pubmed: 2766128
BMJ Case Rep. 2015 Nov 24;2015:
pubmed: 26604230
Clin Neurol Neurosurg. 2012 Nov;114(9):1266-9
pubmed: 22445621
Mayo Clin Proc. 1999 Sep;74(9):893-6
pubmed: 10488791
J Emerg Med. 2006 Aug;31(2):169-71
pubmed: 17044579
Emerg Med J. 2008 Sep;25(9):609-10
pubmed: 18723722
N Engl J Med. 1994 Feb 10;330(6):393-7
pubmed: 8284004
Sports Health. 2016 Jan-Feb;8(1):53-6
pubmed: 26733592
J Vasc Interv Neurol. 2018 Nov;10(2):56-58
pubmed: 30746012
J Neurol Neurosurg Psychiatry. 2009 Feb;80(2):171-4
pubmed: 18977815
N Engl J Med. 2001 Mar 22;344(12):898-906
pubmed: 11259724
Brain Behav. 2015 Aug;5(8):e00349
pubmed: 26356074
J Neurol Sci. 2015 Mar 15;350(1-2):112-4
pubmed: 25680586
Arch Neurol. 1985 Mar;42(3):242-8
pubmed: 3977654
J Cardiovasc Surg (Torino). 1995 Jun;36(3):247-9
pubmed: 7629208
Lancet Neurol. 2015 Apr;14(4):361-7
pubmed: 25684164
Ulus Travma Acil Cerrahi Derg. 2011 Jan;17(1):75-8
pubmed: 21341139
J Trauma. 2002 Jun;52(6):1186-8
pubmed: 12045651
Acta Neurol Scand. 2000 Jan;101(1):70-1
pubmed: 10660157
Neuroradiology. 2003 May;45(5):311-4
pubmed: 12692699
Acta Clin Croat. 2017 Sep;56(3):550-554
pubmed: 29479922
Neurol Sci. 2019 Aug;40(8):1591-1596
pubmed: 30980197
Angiology. 2008 Dec-2009 Jan;59(6):761-4
pubmed: 18388028
Stroke. 2012 May;43(5):1354-61
pubmed: 22403053
Stroke. 1990 Apr;21(4):618-25
pubmed: 2326844
J Neurol Sci. 2016 Jun 15;365:212-3
pubmed: 27206909
J Neurol Neurosurg Psychiatry. 1999 Jun;66(6):804
pubmed: 10400512
Age Ageing. 2008 May;37(3):345-6
pubmed: 18308696
Postgrad Med J. 1997 Jan;73(855):8-16
pubmed: 9039403
Medicine (Baltimore). 2016 Feb;95(5):e2693
pubmed: 26844510
J Neurol Neurosurg Psychiatry. 1989 Oct;52(10):1191-3
pubmed: 2795048
J Neurosci Nurs. 1991 Oct;23(5):287-9
pubmed: 1835991
Stroke. 2007 Sep;38(9):2605-11
pubmed: 17656656
Cerebrovasc Dis. 2014;38(4):247-53
pubmed: 25401389
BMJ Case Rep. 2015 Nov 12;2015:
pubmed: 26564115
Neurocrit Care. 2014 Oct;21(2):253-8
pubmed: 24549934
J Trauma. 2005 Jun;58(6):1285-9
pubmed: 15995485
Neurology. 2006 Sep 26;67(6):1050-2
pubmed: 17000975