[Extracranial vertebral artery dissection repeating distal embolism: case report].
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.
Fujimoto
Kenta
K
Department of Neurosurgery, Nara Medical University, Kashihara, Japan.
Shin
Yasushi
Y
Iida
Jun-ichi
J
Hirabayashi
Hidehiro
H
Nakase
Hiroyuki
H
Kawaguchi
Shoichiro
S
Sakaki
Toshishuke
T
Nakagawa
Hiroyuki
H
Kichikawa
Kimihiko
K
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