title: [Extracranial vertebral artery dissection repeating distal embolism: case report].
abstract: We report a case of vertebral artery (VA) dissection presenting with repeated distal embolism. A 48-year-old man was admitted to our institution with neck pain and vertigo of two day duration. MRI on arrival showed infarction of the left cerebellar hemisphere and the right occipital lobe. Emergency angiography revealed left VA dissection and occlusion of the left posterior inferior cerebellar artery and right calcaline artery. Six hours after admission, he manifested cortical blindness due to embolism of the contralateral left calcaline artery despite giving heparin and aspirin. Thrombolysis was performed but was not successful. We embolized the affected VA to prevent further embolism. We discuss here the indication and timing of treatment for VA dissection presenting with ischemic symptom.
authors.affiliation: Department of Neurosurgery, Nara Medical University, Kashihara, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shin
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Iida
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Hirabayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakase
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Kawaguchi
authors.forename: Toshishuke
authors.initials: T
authors.lastname: Sakaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
mesh_terms: D019575:Blindness, Cortical / Q000209:etiology; D002531:Cerebellum / Q000098:blood supply; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery