Open AccessBilateral vertebral artery dissection complicated by posterior circulation stroke in a young man
Author(s) -
Zhichao Li,
Junni Liu,
Xiang Wang,
Xiaohui Liu,
Qinjian Sun,
Yifeng Du,
Ling Yin
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000022822
Subject(s) - medicine , stroke (engine) , neck pain , vertebral artery dissection , weakness , surgery , dissection (medical) , vertebral artery , engineering , mechanical engineering , alternative medicine , pathology
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.