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Vertebral artery dissection presenting with isolated neck pain
Yakup Krespi1, Mahmut Edip Gurol, Oguzhan Coban
1Department of Neurology, University of Istanbul, Millet cad, Capa, 34390 Istanbul, Turkey. mykrespi@superonline.com
Summary
Vertebral artery dissection (VAD) can present solely as acute neck pain, without neurological symptoms. Early suspicion in young patients is crucial to avoid misdiagnosis and harmful treatments.
Area of Science:
- Neurology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Cervical pain and limited neck movement are common, nonspecific symptoms.
- Vertebral artery dissection (VAD) is often overlooked unless accompanied by neurological deficits.
- VAD typically presents with posterior neck pain and/or occipital headache, often with ischemic symptoms.
Observation:
- Three cases of VAD are presented where acute, unilateral posterior neck pain was the only symptom.
- Patients reported no prior history of similar pain.
- Neurological examinations were unremarkable in all presented cases.
Findings:
- Doppler ultrasonography suggested VAD in two cases.
- T1 fat-suppressed MRI confirmed VAD in all three patients.
- Acute, spontaneous, unilateral posterior cervical pain can be the sole presenting sign of VAD.
Implications:
- Highlights the importance of considering VAD in patients with acute, unexplained neck pain, especially young individuals.
- Emphasizes the need for high clinical suspicion to avoid misdiagnosis.
- Prevents potentially hazardous interventions like physiotherapy or neck manipulation in cases of VAD.