Lessons from the diagnosis and treatment of spontaneous vertebral arterial dissection. Case report.
A 36-year-old man presented a sudden left occipital headache and right limb weakness after tooth-brushing. Conventional catheter digital subtraction angiography (DSA) showed a left VA occlusion at the crotch of the posterior inferior cerebellar artery. Four days later, the patient got worse. The angiogram showed the left vertebral artery had reopened and the basilar trunk occluded above the AICA. He died two days later and autopsy demonstrated a dissection of the basilar arteries. Based on the autopsy data from the patient in this study, we suggest that the BA dissection might be due to left VA dissection, and placing a stent on the juncture between the uninjured VA and the basilar trunk might be an effective method to prevent fatal BA occlusion.
Shi
S
S
Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China - nibingxi@yahoo.com.
Chen
K
K
Ge
X
X
Ni
B
B
Stroke. 1999 May;30(5):1083-90
10229748
N Engl J Med. 1994 Feb 10;330(6):393-7
8284004
Rev Neurol (Paris). 1999 Sep;155(8):575-82
10486847
J Neurosurg. 1991 Dec;75(6):874-82
1941116
Emerg Radiol. 2006 Sep;12(6):254-65
16819638
AJNR Am J Neuroradiol. 2005 Sep;26(8):2095-101
16155164
Ann Otol Rhinol Laryngol. 1999 Dec;108(12):1170-3
10605923
J Neurol Neurosurg Psychiatry. 1994 Nov;57(11):1443
7964839
N Engl J Med. 2001 Mar 22;344(12):898-906
11259724
Neurology. 1988 Jun;38(6):868-77
3368067
AJNR Am J Neuroradiol. 1984 Jan-Feb;5(1):27-34
6421122
AJNR Am J Neuroradiol. 2004 May;25(5):769-74
15140717