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Bilateral Distal Upper Limb Amyotrophy and Watershed Infarcts from Vertebral Dissection
Stroke 25:1870-1872, Pullicino,P., 1994
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Article Abstract
A 39-year-old man developed sudden vertigo,chest and bilateral arm pain, bilateral arm weakness,and wasting involving muscles innervated by the sixth cervical to the first thoracic spine cord segments.Magnetic resonance imaging showed an extensive right vertebral artery dissection and a right posterior inferior cerebellar infarct.Magnetic resonance scans showed a small focal hyperintensity in the region of each anterior horn, extending from the mid to lower cervical spine cord.Minimal recovery of function was present after 3 months.Unilateral vertebral artery dissection may give rise to disabling bilateral upper extremity amyotrophy.Watershed infarction within the anterior spinal artery territory,involving both anterior horns,appears to be the mechanism of the lower motor neuron injury.
 
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anterior horn cell disease
anterior spinal artery infarction
arm weakness
arterial dissection
arterial dissection,vertebral
motor neuron disease
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MRI,spinal cord,increased intramedullary cord signal
muscle atrophy,static
pain,arm
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