[Cerebellar infarction in a young adult due to traumatic vertebral artery dissection after lateral mass fracture at the sixth cervical vertebrae].
A 23-years-old man fell off stairs and got a blow on the left head and right shoulder. He felt dysesthesia at the right thumb on the following day, and received chiropractic therapy from the forth day after injury. On the sixth day after injury, he developed dizziness and nausea, and was urgently hospitalized in our cerebrovascular center. On admission, he had horizontal nystagmus and truncal ataxia. Diffusion-weighted magnetic resonance imaging showed high intensity lesions in right cerebellum hemisphere of posterior inferior cerebellar artery territory, indicating fresh infarcts. On angiogram, right vertebral artery showed tapering occlusion at C6 level, indicating dissection. Computed tomogram showed fracture of the right lateral mass at C6 which extended into the transverse foramen. Under diagnosis of the traumatic vertebral artery dissection due to cervical fracture, we started anticoagulation therapy, which was followed by oral antiplatelet therapy in the chronic stage. Extracranial vertebral artery dissection due to cervical fracture is an important cause of brain infarction in a young adult. Radiological examinations are necessary to rule out traumatic vertebral artery dissection for patients with prolonged dizziness after head injury.
Department of Cerebrovascular Disease and Clinical Research Institute, National Hospital Organization Kyushu Medical Center.
Takefumi
T
Yoshida
Juro
J
Jinnouchi
Kazunori
K
Toyoda
Eiichi
E
Hasegawa
Shigeru
S
Fujimoto
Yasushi
Y
Okada
D000328:Adult; D002531:Cerebellum / Q000098:blood supply*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002574:Cervical Vertebrae / Q000293:injuries*; D003952:Diagnostic Imaging; D050723:Fractures, Bone / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016489:Head Injuries, Closed / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D020217:Vertebral Artery Dissection / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy