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Spontaneous vertebral artery dissection: Posterior circulation stroke.

Deshmukh M, Wadhwa A, Rajdeo R - J Craniovertebr Junction Spine (2015 Oct-Dec)

Bottom Line: Spontaneous vertebral artery dissection (VAD) is relatively rare but an important cause of posterior circulation stroke.The patient was managed conservatively and followed up for 6 months.Follow-up CT angiography after a period of 6 months revealed the near complete resolution of the arterial dissection in left vertebral artery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radio Diagnosis, Lilavati Hospital and Research Center, Mumbai, Maharashtra, India.

ABSTRACT
Spontaneous vertebral artery dissection (VAD) is relatively rare but an important cause of posterior circulation stroke. A 46-year-male complaining of sudden onset headache, neck pain with right-sided neuro deficit in the form of hemiparesis was evaluated by contrast magnetic resonance imaging and dual-energy computed tomography (CT) and brain neck angiography which revealed a short segment extracranial left-sided VAD, associated with acute infarct in the left occipital region. The patient was managed conservatively and followed up for 6 months. Follow-up CT angiography after a period of 6 months revealed the near complete resolution of the arterial dissection in left vertebral artery.

No MeSH data available.


Related in: MedlinePlus

Apparent diffusion coefficient and diffusion-weighted (b = 800 s/mm2) image showing acute infarct in the left occipital region. (b) Apparent diffusion coefficient and diffusion-weighted (b = 800 s/mm2) image showing acute infarct in the left occipital region
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Figure 1: Apparent diffusion coefficient and diffusion-weighted (b = 800 s/mm2) image showing acute infarct in the left occipital region. (b) Apparent diffusion coefficient and diffusion-weighted (b = 800 s/mm2) image showing acute infarct in the left occipital region

Mentions: Contrast magnetic resonance imaging (MRI) angiography with diffusion weighted sequence was performed which revealed acute infarcts in left occipital lobe [Figure 1a and b] along with left VAD involving cervical segment [Figure 2]. Computed tomography (CT) brain and neck angiography with intravenous contrast was performed on Siemens Somatom definition flash 128 slice dual source, dual energy CT scanner which revealed linear, short segment (2.6 cm) dissection of the left vertebral artery at the level of C5-C6 vertebrae with associated aneurysmal dilatation [Figures 3 and 4]. Patient underwent digital subtraction angiography (DSA) which revealed, elevated intimal flap in the left vertebral artery with the development of false lumen showing stagnant contrast, suggestive of dissection, commonly referred as double barrel lumen [Figure 5].


Spontaneous vertebral artery dissection: Posterior circulation stroke.

Deshmukh M, Wadhwa A, Rajdeo R - J Craniovertebr Junction Spine (2015 Oct-Dec)

Apparent diffusion coefficient and diffusion-weighted (b = 800 s/mm2) image showing acute infarct in the left occipital region. (b) Apparent diffusion coefficient and diffusion-weighted (b = 800 s/mm2) image showing acute infarct in the left occipital region
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660499&req=5

Figure 1: Apparent diffusion coefficient and diffusion-weighted (b = 800 s/mm2) image showing acute infarct in the left occipital region. (b) Apparent diffusion coefficient and diffusion-weighted (b = 800 s/mm2) image showing acute infarct in the left occipital region
Mentions: Contrast magnetic resonance imaging (MRI) angiography with diffusion weighted sequence was performed which revealed acute infarcts in left occipital lobe [Figure 1a and b] along with left VAD involving cervical segment [Figure 2]. Computed tomography (CT) brain and neck angiography with intravenous contrast was performed on Siemens Somatom definition flash 128 slice dual source, dual energy CT scanner which revealed linear, short segment (2.6 cm) dissection of the left vertebral artery at the level of C5-C6 vertebrae with associated aneurysmal dilatation [Figures 3 and 4]. Patient underwent digital subtraction angiography (DSA) which revealed, elevated intimal flap in the left vertebral artery with the development of false lumen showing stagnant contrast, suggestive of dissection, commonly referred as double barrel lumen [Figure 5].

Bottom Line: Spontaneous vertebral artery dissection (VAD) is relatively rare but an important cause of posterior circulation stroke.The patient was managed conservatively and followed up for 6 months.Follow-up CT angiography after a period of 6 months revealed the near complete resolution of the arterial dissection in left vertebral artery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radio Diagnosis, Lilavati Hospital and Research Center, Mumbai, Maharashtra, India.

ABSTRACT
Spontaneous vertebral artery dissection (VAD) is relatively rare but an important cause of posterior circulation stroke. A 46-year-male complaining of sudden onset headache, neck pain with right-sided neuro deficit in the form of hemiparesis was evaluated by contrast magnetic resonance imaging and dual-energy computed tomography (CT) and brain neck angiography which revealed a short segment extracranial left-sided VAD, associated with acute infarct in the left occipital region. The patient was managed conservatively and followed up for 6 months. Follow-up CT angiography after a period of 6 months revealed the near complete resolution of the arterial dissection in left vertebral artery.

No MeSH data available.


Related in: MedlinePlus