Bilateral vertebral artery dissection complicated by posterior circulation stroke in a young man: A case report. Issue 44 (30th October 2020)

• Record Type: Journal Article
• Authors: Li, Zhichao; Liu, Junni; Wang, Xiang; Liu, Xiaohui; Sun, Qinjian; Du, Yifeng; Yin, Ling
• Other Names: Saranathan. Maya section editor.
• Is Part Of: Medicine. Volume 99:Issue 44(2020)
• Publication Date: 2020-10-30
• Subjects: bilateral -- case report -- posterior circulation stroke -- stroke management -- vertebral artery dissection; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000022822
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Introduction: Vertebral artery dissection (VAD) is a common cause of stroke in young and mid-aged adults without predisposing risk factors for vascular disease. It can be induced by a particular head or neck posture; its early signs often include headache and neck pain. Improved imaging techniques can be used to detect VAD, whose current treatment options are limited. Patient concerns: The patient presented with neck and shoulder pain for a week after sleeping against the wall with cervical proneness for 1 night. He had sudden headache, slurred speech, and left side weakness for 1.5 hours on admission. Diagnosis: The patient had VAD complicated by posterior circulation stroke. Interventions: Acute stroke was treated with intravenous thrombolytic therapy. Then, the patient was administered follow-up anticoagulants. Outcomes: The patient's condition improved after thrombolytic therapy. He recovered well, with no recurrence during a 4-year follow-up. Conclusion: VAD should be taken into consideration in differential diagnosis of posterior circulation stroke or transient ischemic attack in young patients. Intravenous thrombolytic therapy may be safe and effective for stroke-complicated cases. This case report demonstrates that expanded diagnostic protocol for acute ischemic stroke assures rapid and correct diagnosis.