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[Traumatic extracranial vertebral artery dissection treated with coil embolization--a case report]
Daisuke Matsuura1, Yuichiro Inatomi, Hiroko Saeda
1Stroke Center, Saiseikai Kumamoto Hospital.
Rinsho Shinkeigaku = Clinical Neurology
|May 26, 2005
Summary
A 37-year-old man experienced stroke symptoms due to vertebral artery dissection. Endovascular coil-embolization successfully occluded the dissecting artery, resolving transient ischemic attacks.
Area of Science:
- Neurology
- Vascular Surgery
Background:
- Cervical artery dissection is a significant cause of ischemic stroke in young adults.
- Vertebral artery dissection (VAD) can lead to thromboembolic events affecting the posterior circulation.
Observation:
- A patient presented with vertigo, dysarthria, and left hemiparesis after neck pain.
- MRI revealed a right superior cerebellar artery (SCA) infarct.
- Duplex ultrasound identified dissection in the right vertebral artery (VA) (V2 segment).
- Cerebral angiography confirmed V2 narrowing and right SCA occlusion.
Findings:
- The VAD was diagnosed as the cause of artery-to-artery embolism to the right SCA.
- Despite anti-thrombotic therapy, the patient had recurrent transient ischemic attacks (TIAs).
- Serial imaging showed progressive stenosis and extension of the VAD.
Implications:
- Endovascular coil-embolization of the affected right VA was successfully performed.
- Complete occlusion of the dissecting lesion resolved the patient's TIAs.
- This case highlights the efficacy of endovascular treatment for complex VAD with embolic complications.