[Traumatic vertebral artery dissection causing basilar artery occlusion].

Area of Science:

• Neuroscience
• Vascular Neurology
• Radiology

Background:

• Acute basilar artery occlusion is a critical condition with high mortality, often resulting in brainstem and cerebellar strokes.
• Traumatic vertebral artery dissection is a significant cause of basilar artery occlusion, particularly in younger individuals.

Purpose of the Study:

• To present a case of vertebral artery dissection leading to basilar artery occlusion and subsequent neurological deficits.
• To emphasize the importance of considering vertebral artery dissection in polytraumatized patients or those with specific neck injury mechanisms.

Main Methods:

• Case report of a 23-year-old female with a history of a traffic accident.
• Diagnostic imaging included computed tomographic angiography (CTA) and cranial magnetic resonance (MR) examination.
• Assessment of neurological deficits, including cortical blindness.

Main Results:

• The patient presented with severe neurological deficits, including cortical blindness, 4 days after a traffic accident.
• CTA revealed complete occlusion of the basilar artery and dissection of the right vertebral artery.
• Cranial MR confirmed complete emollition (infarction) of both visual cortices.

Conclusions:

• Vertebral artery dissection should be suspected in polytraumatized patients or following sudden neck movements (e.g., whiplash).
• Extracranial vascular dissection can occur without apparent fractures or cervical spine injuries.
• Radiological investigation for vertebral artery dissection is crucial when basilar artery occlusion is diagnosed.