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Dissection of the Extracranial Vertebral Artery:Report of Four Cases and Review of the Literature
JNNP 54:863-869, Hinse,P.,et al, 1991
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Article Abstract
Four cases of cervical vertebral artery(VA)dissection are reported.In three patients VA dissection was associated with neck trauma.All patients were young or middle-aged(range 27 to 49 years).In two there was a history of migraine.Pain preceded neurological symptoms from hours to six weeks. Three patients had neurological deficits including elements of the lateral medullary syndrome,and one experienced recurrent transient ischaemic attacks in the vertebrobasilar territory.Angiographic findings included irregular stenosis,occlusion and pseudoaneurysm;in two patients VA abnormalities were bilateral.All patients were treated with anticoagulants and improved.In a review of 28 cases with traumatic dissection and 29 cases with spontaneous dissection of the VA reported in the literature, distinct clinical and angiographic features emerge.Aetiology remains obscure in most cases of spontaneous dissection and management is still controversial.
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angiography,posterior fossa
anticoagulant,treatment
anticoagulant,treatment in CVD
arterial dissection
arterial dissection,vertebral
brainstem,infarction of
carotid angiogram
cerebrovascular accident,young adult
cervical spine injury
controversies in neurology
neck pain
pain
posterior inferior cerebellar artery syndrome
prognosis
review article
transient ischemic attack
trauma
treatment of neurologic disorder
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