Vertebral artery dissection (VAD) is a cause of brain stem stroke in the younger population and is commonly associated with trauma, sudden neck movement, or chiropractic manipulations. In this case, a 28-year-old male with a non-significant past medical history who recently started a CrossFit boot camp presented to the emergency department with right-sided neck pain, dysarthria, mild right gaze paresis, right dysmetria, and right facial droop with symptoms of Horner’s syndrome. Imaging results revealed an age-indeterminate left lateral cerebellar infarct with right VAD. The goal of management is to prevent stroke, which is done with anticoagulation and potentially thrombolytic therapy if there are no contraindications. The patient received thrombolytic therapy and was treated with conservative management. The prognosis is good for patients who survive the initial dissection and are treated in this manner. It is important to obtain a thorough history of young and healthy patients who present with concerning neurologic symptoms so that precipitating activities are not missed.

We compare the evolution of binary systems evolved in the MESA stellar evolution code to those in the COSMIC population synthesis code. Our aim is to convey the robustness of the equations that model binary evolution in the COSMIC code, particularly for the cases of high mass stars with closely orbiting compact object companions. Our larger goal is to accurately model the rates of these systems, as they are promising candidates for the progenitor systems behind energetic, longer lasting, radio bright GRB jets. These systems also may be key contributors to the rates of binary black hole mergers throughout our Universe.