Cervical root injury caused by vertebral artery dissection

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• Vertebral artery dissection is a frequent cause of stroke in young adults, typically affecting the posterior circulation.
• Peripheral motor deficits are uncommon manifestations of vertebral artery dissection, potentially resulting from spinal nerve compression or ischemia.
• Spinal radicular artery occlusion originating from the vertebral artery can lead to anterior horn or spinal nerve ischemia.

Purpose of the Study:

• To report a rare case of vertebral artery dissection presenting with peripheral motor deficit and recurrent central ischemic neurological events.
• To underscore the diagnostic utility of Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) in identifying vertebral artery dissection.
• To emphasize the importance of timely anticoagulant therapy in managing vertebral artery dissection to prevent neurological deterioration.

Main Methods:

• Case report detailing a patient with vertebral artery dissection.
• Review of clinical presentation, diagnostic imaging findings (MRI/MRA), and treatment outcomes.
• Discussion of potential pathophysiological mechanisms for peripheral motor deficits in vertebral artery dissection.

Main Results:

• The patient presented with an unusual peripheral motor deficit in the upper limb.
• Recurrent central ischemic neurological events were observed in association with the vertebral artery dissection.
• Diagnosis was confirmed using non-invasive Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA).

Conclusions:

• Vertebral artery dissection can manifest with rare peripheral motor deficits and recurrent ischemic events.
• Early diagnosis via MRI/MRA and prompt anticoagulation are crucial for managing vertebral artery dissection and preventing complications.
• This case expands the spectrum of clinical presentations associated with vertebral artery dissection.