title: Occlusion of the vertebral artery secondary to dissection of the subclavian artery--case report.
abstract: A 34-year-old man presented with occlusion of the left vertebral artery (VA) secondary to dissection of the left subclavian artery manifesting as vertigo, nausea, vomiting, and neck pain. On admission, he was alert with left limb and truncal ataxia. Magnetic resonance (MR) imaging and MR angiography showed left cerebellar infarction and occlusion of the left VA. Conventional angiography and three-dimensional computed tomography (3D-CT) angiography showed stenosis with thrombosed pseudo-lumen of the left subclavian artery, and occlusion of the left VA. Presumably the idiopathic dissection of the left subclavian artery had reached the orifice of the left VA, and an embolism from the dissection had caused occlusion of the VA, leading to cerebellar infarction. After one month, he was discharged without severe neurological deficits. Idiopathic dissection of the subclavian artery is very rare. 3D-CT angiography is very useful for the diagnosis of arterial dissection.
authors.affiliation: Department of Neurosurgery, Kokura Memorial Hospital, 1-1 Kifune-machi, Kokura-kita-ku, Kitakyushu, Fukuoka 802-8555, Japan. yiwamuro@tc4.so-net.ne.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Iwamuro
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakahara
authors.forename: Masato
authors.initials: M
authors.lastname: Tanaka
authors.forename: Toshio
authors.initials: T
authors.lastname: Higashi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Kei
authors.initials: K
authors.lastname: Harada
authors.forename: Motoaki
authors.initials: M
authors.lastname: Fujimoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Oku
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D013348:Subclavian Artery; D014711:Vertebral Artery