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Spontaneous vertebral artery dissection mimicking acute vertigo. Case report
I Braverman1, Y River, J M Rappaport
1Department of Otolaryngology-Head and Neck Surgery, Hadassah University Hospital, Jerusalem, Israel.
The Annals of Otology, Rhinology, and Laryngology
|December 22, 1999
Summary
Vertebral artery dissection (VAD) can present as acute vertigo, mimicking peripheral causes. This case highlights the importance of considering VAD in vertigo patients with normal neurological exams.
Area of Science:
- Neurology
- Vascular Neurology
- Neuro-otology
Background:
- Acute vertigo is a common presenting symptom in clinical practice.
- Differential diagnosis for vertigo includes central and peripheral causes.
- Vertebral artery dissection (VAD) is a potentially devastating condition that can affect the posterior circulation.
Observation:
- A patient presented with acute vertigo.
- Neurologic examination findings were normal.
- The patient was diagnosed with vertebral artery dissection (VAD).
Findings:
- The clinical presentation of VAD in this case mimicked vertigo of labyrinthine (peripheral) origin.
- Normal neurologic examination does not exclude central causes like VAD.
Implications:
- This case underscores the need for a high index of suspicion for VAD in patients with acute vertigo, even with a normal neurologic examination.
- Early diagnosis and management of VAD are crucial to prevent severe neurological deficits.
- Clinicians should consider vascular imaging in the evaluation of unexplained vertigo.