Bilateral vertebral artery dissection in a patient with afibrinogenemia.
BACKGROUND
Afibrinogenemia, a rare coagulation disorder, has not been associated with vertebral artery dissections.


METHODS
A 28-year-old woman with afibrinogenemia developed spontaneous neck pain followed by a right medullary infarction, and MR angiography showed extensive bilateral vertebral artery dissection. She was treated with fibrinogen replacement and anticoagulants and showed a favorable evolution, with only mild residual right upper arm incoordination.


CONCLUSIONS
In this patient spontaneous bilateral vertebral artery dissection complicated afibrinogenemia. Since anticoagulant therapy is usually indicated for arterial dissection, this association created a therapeutic problem. This patient received anticoagulants with fibrinogen replacement, which resulted in a favorable evolution.
García-Moncó
J C
JC
Neurology Department, Hospital de Galdacano, Vizcaya, Spain. hospit05@.sarenet.es
Fernández Cantón
G
G
Gómez Beldarrain
M
M
D000328:Adult; D000347:Afibrinogenemia / Q000150:complications* / Q000188:drug therapy; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D000925:Anticoagulants / Q000627:therapeutic use; D000075202:Contraindications; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D019547:Neck Pain / Q000209:etiology; D014711:Vertebral Artery / Q000473:pathology; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin; D005340:Fibrinogen; D006493:Heparin