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A young woman experienced stroke-like symptoms due to severe carotid and vertebral artery disease. Her condition resolved spontaneously, suggesting reversible cerebral vasoconstriction syndrome or spontaneous arterial dissection.
Area of Science:
- Vascular Neurology
- Neuroimaging
Background:
- Cerebrovascular diseases can present with diverse neurological symptoms.
- Extracranial arterial disease poses a risk for ischemic events.
Observation:
- A 26-year-old woman presented with subacute headache, hypertension, and neurological deficits.
- Initial angiography showed severe extracranial carotid and vertebral artery disease, including stenoses and dilatations.
Findings:
- Medical management led to initial improvement.
- Recurrent symptoms prompted repeat angiography, revealing normal vasculature.
- The findings suggest spontaneous arterial dissections with subsequent recovery.
Implications:
- This case highlights the possibility of transient, severe extracranial arterial disease.
- Spontaneous dissections should be considered in young adults with unexplained cerebrovascular events.
- The potential for vascular recovery underscores the importance of careful follow-up.
Abstract:
A 26 year old woman presented with a subacute onset of headache, hypertension, and neurologic impairment. Angiography revealed severe extracranial carotid and vertebral artery disease. Long segmental stenoses, lumen irregularities, and aneurysmal dilatations were noted. She improved with medical management and was followed for one year. Because recurrent neurologic symptoms developed, angiography was repeated and disclosed normal vasculature. "Spontaneous dissections" with recovery are the most probable explanation for this phenomenon.