Atraumatic Vertebral Dissection in a Patient With Altered Mental Status

The most common manifestations of vertebral artery dissection in approximately 80% of patients are headaches or neck pain. We discuss a case of a 34-year-old patient who presented to the emergency department with altered mental status and nonspecific symptoms. A CT angiogram with intravenous contrast revealed a dissection of the left vertebral artery, and the patient was found to have thromboembolism in the right occipital lobe with ischemia on MRI. This case demonstrates the importance of maintaining a broad differential diagnosis for patients who present with altered mental status and nonspecific symptoms such as headache and neck pain in order to adequately diagnose a potentially fatal condition.