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Vertebral Artery Dissection Following Cervical Spine Injury as a Diagnostic Challenge. Case Study
Barbara Dobies-Krześniak1, Beata Tarnacka2
1Klinika Rehabilitacji, Warszawski Uniwersytet Medyczny, I Wydział Lekarski, Warszawa, Polska / Department of Rehabilitation, Medical University of Warsaw, 1st Faculty of Medicine, Warsaw, Poland.
Abstract:
Head and neck injuries are common and can be associated with cervical vessel injury. In some cases, the cor-rect diagnosis of artery dissection can be a real challenge given the nonspecific signs. We present the case of a spinal cord-injured patient with neurological sequelae and delayed posterior circu-la-tion stroke caused by bilateral vertebral artery dissection. The signs of cerebellar and occipital lobe ischemia were masked by manifestations of spinal cord injury. The patient was unconscious and in a serious condition, but, despite no proper stroke treatment, only residual dysarthria and upper limb ataxia were seen after reha-bilitation. Any clinical suspicion based on the combination of head or neck trauma with atypical or evolving neuro-logical symptoms should be verified for the possibility of a vertebral artery dissection.
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