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Atraumatic Vertebral Dissection in a Patient With Altered Mental Status
Tina Kana1, Dena Alsurakhi1, Ahmed Kawamj2
1Internal Medicine, Touro College of Osteopathic Medicine, New York, USA.
Cureus
|May 4, 2023
Summary
Vertebral artery dissection often presents as headache or neck pain. Early diagnosis is crucial, as this case highlights altered mental status and nonspecific symptoms indicating potential stroke.
Area of Science:
- Neurology
- Vascular Neurology
- Radiology
Background:
- Vertebral artery dissection (VAD) is a significant cause of stroke in young adults.
- Headache and neck pain are the most common initial symptoms, occurring in up to 80% of cases.
- VAD can lead to serious complications, including ischemic stroke due to thromboembolism.
Observation:
- A 34-year-old patient presented with altered mental status and nonspecific symptoms.
- Computed tomography (CT) angiography with intravenous contrast identified a left vertebral artery dissection.
- Magnetic resonance imaging (MRI) confirmed a right occipital lobe thromboembolism and ischemia.
Findings:
- The patient's presentation with altered mental status and nonspecific symptoms mimicked other conditions.
- The vertebral artery dissection was the underlying cause of the ischemic stroke.
- Prompt diagnostic imaging was essential for identifying the dissection and subsequent embolism.
Implications:
- This case underscores the necessity of including VAD in the differential diagnosis for patients with unexplained altered mental status, headache, or neck pain.
- Timely diagnosis and management of VAD are critical to prevent potentially fatal outcomes like stroke.
- Broadening the diagnostic approach for nonspecific neurological symptoms can improve patient outcomes in vascular emergencies.
