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Vertebral Artery Dissection: A Pain in the Neck
Brian R Covello1, Anjeza Chukus1
1Radiology, Aventura Hospital and Medical Center, Aventura, USA.
Cureus
|March 4, 2021
Summary
Spontaneous vertebral artery dissection (VAD) can cause ischemic stroke in young adults, often presenting with neck pain and headache. Early diagnosis and treatment are crucial for preventing long-term neurological damage.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Vertebral artery dissection (VAD) is a significant cause of ischemic stroke, particularly in younger populations.
- VAD often presents with non-specific symptoms like neck pain and headache, potentially delaying diagnosis.
Observation:
- A 42-year-old male presented with isolated neck pain and headache, leading to incidental discovery of an anterior communicating artery aneurysm.
- Digital subtraction angiography, performed for the aneurysm, revealed a spontaneous left vertebral artery dissection as the cause of his symptoms.
Findings:
- The vertebral artery dissection (VAD) resulted in a small acute left occipital lobe infarct due to thromboembolism.
- The patient's symptoms resolved after endovascular coiling of the aneurysm and aspirin treatment for the VAD.
Implications:
- This case highlights the importance of considering VAD in young adults with craniocervical pain, even without overt neurological deficits.
- Prompt diagnosis using imaging like CT angiography or MRA, alongside DSA, is vital for effective management and reducing stroke-related sequelae.
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