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At least 163 records · Page 9Linked to original sources
PubMed2002

Sudden onset pharyngeal pain associated with dissecting vertebral artery aneurysm.

BACKGROUND AND PURPOSE: We report a case of sudden onset pharyngeal pain due to dissection of the vertebral artery. CASE DESCRIPTION: A 65-year-old patient presented with sudden onset of unilateral pharyngeal pain, which was first, diagnosed as idiopathic glossopharyngeal neuralgia. Magnetic resonance image and cerebral angiography revealed a dissecting vertebral artery aneurysm. The anatomical site of the aneurysm may explain this complication. CONCLUSIONS: Sudden onset of pharyngeal pain, although rare, should be considered as a complication of dissection of the vertebral artery even though there are no other general or neurological symptoms.

Aged↗
PubMed1995

Treatment of vertebral artery dissecting aneurysm by aneurysm trapping and posterior inferior cerebellar artery reimplantation. Case report.

The author presents the case of a patient with a ruptured vertebral artery dissecting aneurysm in which the posterior inferior cerebellar artery (PICA) arose from the wall of the aneurysm. The aneurysm was treated by trapping and the PICA was anastomosed to the vertebral artery proximal to the dissection. This technique allows intraoperative obliteration of the aneurysm while maintaining normal blood flow to the PICA.

Aortic Dissection↗
PubMed1998

Traumatic vertebral arterial dissection and vertebrobasilar arterial thrombosis successfully treated with endovascular thrombolysis and stenting.

A case of traumatic extracranial vertebral arterial dissection leading to vertebrobasilar thrombosis and respiratory compromise requiring mechanical ventilation was managed with intraarterial thrombolysis and stenting of the vertebral intimal dissection. In contrast to similar, previously reported cases, this critically ill patient made a full recovery, returning to his job as a secondary school teacher.

Adult↗
PubMed2002

Recurrent torticollis caused by dissecting vertebral artery aneurysm in a pediatric patient: results of endovascular treatment by use of coil embolization: case report.

OBJECTIVE AND IMPORTANCE: Torticollis is a symptom that can be related to different pathological mechanisms ranging from simple to life-threatening conditions. We report a child with recurrent torticollis caused by an intracranial dissecting vertebral artery aneurysm. This is a very rare condition in childhood, and it was resolved successfully with endovascular treatment. CLINICAL PRESENTATION: The patient was a 10-year-old boy with a 4-year history of left recurrent torticollis, followed by hemiparesis, dysarthria, dysmetria, and tremor. Brain magnetic resonance imaging and digital angiography detected a dissecting aneurysm involving the fourth segment of the left vertebral artery. INTERVENTION: The patient underwent endovascular treatment. Coil embolization, followed by histoacryl injection into the lesion, provided complete obliteration of the aneurysmal sac. CONCLUSION: The patient's postoperative course was characterized by a dramatic disappearance of symptoms and signs within a few hours of the intervention. No relapses of symptoms occurred during a follow-up period of 18 months. This is the first report of a child in whom recurrent torticollis was related to a dissecting vertebral artery aneurysm. Although long-term results of vertebral artery coil embolization remain to be elucidated, the method seems reliable and effective in treatment of these vascular lesions in pediatric patients.

Angiography, Digital Subtraction↗
PubMed2004

[Bilateral vertebral artery dissection and its chronological changes detected by MR angiography: a case report].

A case of intracranial bilateral vertebral artery (VA) dissection presenting with ischemic symptoms which following unilateral dissection is presented. A 42-year-old male with an occipital headache was pointed out right vertebral artery stenosis with magnetic resonance (MR) angiography 8 day before admission. He admitted to our hospital complaining of severe vertigo and tinnitus. MR images and cerebral angiograms revealed bilateral VA dissection with infarcts in light lower surface of cerebellum perfused by posterior inferior cerebellar artery and right hypothalamus. Conservative therapy was adopted and serial MR angiography was performed. His symptoms were improved gradually and MR angiograms obtained 2 months later revealed improvement of bilateral VA stenosis. It is generally accepted that VA dissection presenting ischemic symptoms has good outcome by conservative therapy only. However, its pathological process of progression is still unknown. Based on the serial MR findings, we discuss the mechanisms of bilateral VA dissection. In this case, we consider that unilateral VA dissection extended to contralateral vertebral artery through the vertebrobasilar junction. Frequent MR angiography in acute phase could be of great use for monitoring the progression of dissection.

Acute-Phase Reaction↗
PubMed2006

Vertebral artery dissection: presenting findings and predictors of outcome.

BACKGROUND AND PURPOSE: Few data exist about clinical, radiologic findings, clinical outcome, and its predictors in patients with spontaneous vertebral artery dissection (sVAD). METHODS: Clinical characteristics, imaging findings, 3-month outcomes, and its predictors were investigated in consecutive patients with sVAD. RESULTS: One hundred sixty-nine patients with 195 sVAD were identified. Brain ischemia occurred in 131 patients (77%; ischemic stroke, n=114, 67%; transient ischemic attack, n=17, 10%). Three patients with ischemic stroke showed also signs of subarachnoid hemorrhage (SAH); 3 (2%) had SAH without ischemia. The 134 patients with brain ischemia or SAH had head and/or neck pain in 118 (88%) and pulsatile tinnitus in seven (5%) patients. The remaining 35 patients (21%) had isolated head and/or neck pain in 21 (12%) cases, asymptomatic sVAD in 13 (8%), and cervical radiculopathy in one case (1%). Location of sVAD was more often in the pars transversaria (V2; 35%) or atlas loop (V3; 34%) than in the prevertebral (V1; 20%) or intracranial (V4; 11%) segment (P=0.0001). Outcome was favorable (modified Rankin scale score 0 or 1) in 88 (82%) of 107 ischemic stroke patients with follow up. Two (2%) patients died. Low baseline National Institutes of Health Stroke Scale score (P<0.0001) and younger age (P=0.007) were independent predictors of favorable outcome. CONCLUSIONS: sVAD is predominantly located in the pars transversaria (V2) or the atlas loop (V3). Most patients show posterior circulation ischemia. Favorable outcome is observed in most ischemic strokes and independently predicted by low National Institutes of Health Stroke Scale score and younger age.

Brain Ischemia↗
PubMed1995

Vertebral artery dissection complicated by cervical manipulation: a case report.

A 32-year-old healthy man developed vomiting, blurred vision, and consciousness disturbance following cervical manipulation. Physical examination showed stuporous consciousness and spontaneous horizontal nystagmus. Computed tomography (CT) and magnetic resonance (MR) imaging of the brain revealed infarction in the territory of the basilar artery. Studies of MR angiography and vertebral angiography disclosed dissection of the right vertebral artery at the atlantoaxial segment. Antiedematous drugs were prescribed and the patient gradually improved. Neurologic examination six months later demonstrated mild cerebellar ataxia. Physicians and patients should be aware that vertebro-basilar dissection may follow cervical manipulation, and, more importantly, should attempt to prevent progressive infarction.

Adult↗
PubMed2006

Segmental disruption of internal elastic lamina in spontaneous vertebral artery dissection combined with redundancy of multiple cervical arteries.

A 49-year-old man developed a spontaneous vertebral artery dissection leading to cerebellar and brain stem infarction. Cerebral angiograph demonstrated redundancy, including kinks, loops and coils, in multiple cervicocephalic arteries, in addition to the dissecting artery. Histological examination of the superficial temporal artery revealed segmental disruptions of the internal elastic lamina and intimal abnormalities. These ultrastructural abnormalities may impair vessel wall integrity and predispose to nontraumatic arterial dissection and vascular tortuosity.

Basement Membrane↗
PubMed1994

[Vertebral artery dissection. Clinical aspects, non-invasive diagnosis, therapy--observations in 14 patients].

We report 14 patients with so called spontaneous vertebral artery dissection. Dissection site was the atlanto-axial (V3) segment in 12 patients, the intertransverse (V2) in 5 and the intracranial (V4) in 3. Two had additional carotid artery dissection. Typical clinical presentation of symptoms consisted in unilateral, acute, severe neck and occipital head pain (12/14) simultaneously with, or followed by signs of vertebrobasilar ischemia (12/14). The later may be Wallenberg's syndrome (7/14), a cerebellar (5/14) or a vestibular syndrome. When this constellation is present in a young patient and preceded by a "trivial" head or neck trauma dissection should be suspected in cases without vascular risk factors. According to our results, MRI today is the method of choice to confirm diagnosis. Mural hematoma can be shown non invasively (12/13). Angiography is only rarely indicated. Doppler- and duplex sonography of posterior circulation is more difficult and results are less conclusive than with the carotid system. Nevertheless, we found abnormal results in 86% and definite pathologic results in 64% of our patients when combining both methods. Immediate anticoagulation appears to be an adequate treatment when intracranial dissection is excluded. Its effectiveness, however, has not been demonstrated. None of the 12 anticoagulated patients showed deterioration.

Adult↗
PubMed2003

Postoperative bilateral vertebral artery dissection: a case report.

With the improvement of medical imaging and surgical techniques, surgery on cervical vertebral is more frequent. Some cases of complications of this type of surgery have been described. We report a case of postoperative bilateral vertebral artery dissection. It concerns a 58 year-old woman who suffered from a left cervico-brachial C6 neuralgia with paresthesiae of the thumb. She underwent discectomy at C5-C6 and C6-C7 followed by setting up intersomatic cages. In subsequent days, an irreversible coma developed. Supra-aortic echographic study revealed bilateral vertebral artery thrombosis. CT scan revealed ischemic lesions of the brain stem and cerebellum. Cerebral death was declared five days after the operation. Autopsy was performed to determine whether death was the consequence of the intervention. The cause of death was determined to be ischemic brain injury of the brain stem and cerebellum resulting from bilateral traumatic occlusion of the vertebral arteries caused by the surgery.

Journal Article↗
PubMed1997

Vertebral artery dissection not detected by initial angiography--case report.

A 57-year-old male presented with subarachnoid hemorrhage caused by vertebral artery dissection. The first cerebral angiogram on the day of ictus found minimal caliber change with lower contrast density at the V4 segment, but repeat angiography showed typical segmental narrowing of the artery on the 14th day. Repeat angiography with magnetic resonance imaging in the subacute stage would be useful to identify the cause of "angiogram-negative" subarachnoid hemorrhage.

Cerebral Angiography↗
PubMed1991

Extracranial vertebral artery dissection following tonic clonic seizure.

A 34 year old woman developed cerebral infarction, following a tonic-clonic seizure. A vertebral artery dissection was demonstrated and may have been caused by arterial trauma during the seizure. This cause of morbidity following convulsive seizures may have been overlooked in the past and needs to be recognised in view of the potential benefits of anticoagulation.

Adult↗
PubMed1993

Distal ligation and revascularization from external carotid to vertebral artery with radial artery graft for treatment of extracranial vertebral artery dissection. Report of a case.

We present a case of dissection of the extracranial vertebral artery with prominent occipital pain and elements of the lateral medullary syndrome. Arteriography showed a string and pearl sign. Magnetic resonance imaging allowed visualization of an intramural thrombus associated with a narrow vascular lumen. The distal portion of the diseased artery was ligated and vascular reconstruction using an interposed radial artery graft was performed. Pathological studies confirmed the diagnosis. The diagnostic roles of angiography and magnetic resonance imaging, and therapeutic strategies are discussed.

Adult↗
PubMed2003

Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature.

Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation.

Adult↗
PubMedDate not supplied

Vertigo as manifestation of vertebral artery dissection after chiropractic neck manipulations.

We recently observed a case of vertebral artery (VA) dissection following chiropractic neck manipulations. The first manifestation was unusual; in the form of vertigo. Therefore, the patient was referred to the otoneurologist. A VA dissection should be suspected in a case of vertigo following chiropractic neck manipulations, and vestibular tests should be done carefully, avoiding Rose's positions. In our case, the diagnosis was based on Doppler sonography and angiography. Chiropractic neck manipulations are the most frequent cause of traumatic VA dissection. Practitioners should be aware that, in some cases, these manoeuvres are life threatening.

Adult↗
PubMed2003

Vertebral artery dissection in an infant: ultrastructural aberrations in connective tissue components.

We report on a 14-month-old boy who had acute multiple infarcts in the posterior circulation due to an extremely early onset of spontaneous vertebral artery dissection. Despite the absence of clinical signs of connective tissue disorders, an ultrastructural change of collagen fibrils and elastic fibers indicated connective tissue abnormalities. Arterial dissection should be considered as a cause of stroke during infancy.

Elastic Tissue↗