Open AccessVertebral Artery Dissection Mimicking Migraine: A Case Report
Author(s) -
Rahalkar Kshitij,
Hong K. Lau,
R Ponampalam
Publication year - 2021
Publication title -
emergency medicine
Language(s) - English
Resource type - Journals
ISSN - 2379-4046
DOI - 10.17140/emoj-7-162
Subject(s) - medicine , vertebral artery dissection , radiology , vertebral artery , neck pain , magnetic resonance imaging , magnetic resonance angiography , stroke (engine) , carotid artery dissection , dissection (medical) , subarachnoid hemorrhage , angiography , aneurysm , cervical artery , thrombus , migraine , arterial dissection , surgery , mechanical engineering , alternative medicine , pathology , engineering
Vertebral artery dissection (VAD) is caused by an intimal tear that leads to bleeding into the vascular wall, which may cause vascular occlusion by thrombus formation and subsequent distal emboli (leading to ischemic stroke), aneurysm formation and subarachnoid hemorrhage. Cervical artery dissections (either carotid or vertebral artery dissection) are an important cause of stroke in patients under 50-years of age. Headache with or without neck pain is a common symptom. Usually, it occurs with focal neurological signs but sometimes it may occur without any neurological deficits and may mimic migraine. Often it occurs spontaneously without trauma but sometimes there is history of minor traumas, sudden neck movements or chiropractic manipulation. Imaging modalities include magnetic resonance imaging (MRI) brain, magnetic resonance angiography (MRA), and computed tomography angiography (CTA). Treatment involves anticoagulation or antiplatelet agents.