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A headache not to be sneezed at.
1Department of Anaesthetics, Royal Berkshire NHS Foundation Trust, Reading, UK. davidgarry2000@yahoo.co.uk
Emergency Medicine Journal : EMJ
|April 24, 2009
Summary
A patient with headache and vertigo after neck trauma was diagnosed with vertebral artery dissection (VAD). Early diagnosis via MRI/MRA is crucial for managing this rare but serious condition.
Area of Science:
- Neurology
- Vascular Medicine
Background:
- Headache and vertigo are common emergency department presentations.
- Neck trauma can precipitate rare neurological emergencies like vertebral artery dissection (VAD).
Observation:
- A 32-year-old male presented with headache and vertigo after sneezing, with a history of neck trauma.
- Neurological examination revealed horizontal nystagmus and gait instability.
- Computed tomography ruled out hemorrhage, and aspirin was administered.
Findings:
- Magnetic resonance imaging and angiography confirmed vertebral artery dissection (VAD).
- The Cervical Artery Dissection in Stroke Study (CADISS) is investigating optimal treatment for VAD.
Implications:
- Prompt neurological examination is vital for diagnosing rare causes of common symptoms like headache.
- Accurate diagnosis of VAD is essential for appropriate management and stroke prevention.
- Ongoing research, such as the CADISS trial, aims to determine the best therapeutic strategies for VAD.
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