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Bilateral vertebral artery dissection causing a cerebrovascular accident in pregnancy. A case report
S B Mass1, E Cardonick, S Haas
1Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Background:
Vertebral artery dissection, occurring spontaneously or following a traumatic event, is a cause of posterior circulation stroke in young individuals, including pregnant women.
Case:
A 20-year-old, primagravid woman acutely developed headache, right-sided hemiparesis and parasthesias, and blurred vision. Within days she complained of cervical neck pain. Magnetic resonance imaging findings were consistent with a posterior circulation cerebrovascular accident (CVA). An arteriogram, performed to exclude vasculitis, revealed bilateral vertebral artery dissection. No inciting event could be recalled.
Conclusion:
Vascular dissections occur rarely during pregnancy. Spontaneous extracranial vertebral artery dissection itself is very rare in general. Cerebral ischemia can follow vertebral artery dissection. In young patients with CVA, consideration of the diagnosis of vertebral artery dissection followed-by angiography and anticoagulation is an important component of the workup and care.