Lessons from the Diagnosis and Treatment of Spontaneous Vertebral Arterial Dissection

Abstract

<jats:p> A 36-year-old man presented a sudden left occipital headache and right limb weakness after tooth-brushing. Conventional catheter digital subtraction angiography (DSA) showed a left VA occlusion at the crotch of the posterior inferior cerebellar artery. Four days later, the patient got worse. The angiogram showed the left vertebral artery had reopened and the basilar trunk occluded above the AICA. He died two days later and autopsy demonstrated a dissection of the basilar arteries. Based on the autopsy data from the patient in this study, we suggest that the BA dissection might be due to left VA dissection, and placing a stent on the juncture between the uninjured VA and the basilar trunk might be an effective method to prevent fatal BA occlusion. </jats:p>

Three cases of Spontaneous Vertebral Artery Dissection (SVAD), resulting in two cases of Wallenberg syndrome and one case of Foville syndrome in young, healthy men

“…VA dissection has become increasingly recognised as an important cause of stroke, especially in young and middle age patients 1. The most important clinical symptoms of a spontaneous VA dissection are unilateral headache and neck pain in 55–60% 2.…”

Spontaneous Bilateral Vertebral Artery Dissection During a Basketball Game

“… 4 It is a rare cause of ischemic stroke, comprising 2% of all ischemic strokes. 30 However, in patients younger than 45 years, SVAD accounts for 20% of all ischemic strokes, with an annual incidence of 2.6 to 5 in 100,000. 3 Recently, the incidence of SVAD has increased, in part because of the higher use of modern diagnostic imaging studies rather than a true increase.…”