Simultaneous, spontaneous and multivessel cervical artery dissection presenting with headache and vertigo

Area of Science:

• Neurology
• Vascular Medicine
• Radiology

Background:

• Cervical artery dissection (CAD) is a significant cause of ischemic stroke, especially in younger populations.
• Spontaneous, non-traumatic CAD typically involves a single vessel, with multivessel involvement being rare.

Observation:

• A young adult male presented with spontaneous, non-traumatic CAD affecting four cervical arteries.
• The patient experienced bilateral cerebellar infarcts and a basilar artery thrombus.

Findings:

• This case represents a rare occurrence of extensive multivessel CAD (quadruple dissection) without trauma.
• The findings underscore the potential severity and complexity of spontaneous CAD.

Implications:

• Clinicians must maintain a high index of suspicion for CAD, even in the absence of trauma.
• Thorough clinical examination and advanced imaging are crucial for diagnosing extensive CAD and associated complications.
• Awareness of rare presentations like multivessel CAD is vital for timely and effective patient management.