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Published on: February 26, 2013
Bilateral vertebral artery dissection in a patient with afibrinogenemia
J C García-Moncó1, G Fernández Cantón, M Gómez Beldarrain
1Neurology Department, Hospital de Galdacano, Vizcaya, Spain. hospit05@.sarenet.es
Background:
Afibrinogenemia, a rare coagulation disorder, has not been associated with vertebral artery dissections.
Case Description:
A 28-year-old woman with afibrinogenemia developed spontaneous neck pain followed by a right medullary infarction, and MR angiography showed extensive bilateral vertebral artery dissection. She was treated with fibrinogen replacement and anticoagulants and showed a favorable evolution, with only mild residual right upper arm incoordination.
Conclusions:
In this patient spontaneous bilateral vertebral artery dissection complicated afibrinogenemia. Since anticoagulant therapy is usually indicated for arterial dissection, this association created a therapeutic problem. This patient received anticoagulants with fibrinogen replacement, which resulted in a favorable evolution.
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