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Updated: Jun 3, 2026
08:22
Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
"Ostrich sign" indicates bilateral vertebral artery dissection
David Z Rose1, M Rizwan Husain
1Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. dzr3s@aol.com
Summary
Bilateral vertebral artery dissections (VADs) can occur from neck trauma. A new "ostrich sign" on MRI aids rapid diagnosis of these rare, stroke-causing injuries.
Area of Science:
- Neurology
- Vascular Imaging
- Radiology
Background:
- Vertebral artery dissections (VADs) are a rare cause of ischemic stroke, often linked to neck trauma or specific activities.
- Prompt diagnosis is crucial for managing VADs and preventing complications like stroke.
Observation:
- A case of bilateral extracranial VAD is presented as a complication of conducting an orchestra, an unprecedented cause.
- Vigorous neck movements during conducting may induce excessive rotational forces on vertebral arteries.
Findings:
- Axial magnetic resonance angiography (MRA) of bilateral VADs revealed a distinct pattern resembling an ostrich's face.
- This unique MRA finding has been termed the "ostrich sign" to facilitate rapid identification.
Implications:
- The "ostrich sign" offers a novel visual cue for diagnosing bilateral VADs on MRA.
- Early recognition of VADs, aided by this sign, is critical for preventing stroke and managing potential aneurysms or occlusions.
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