title: Vertebral artery dissection as a cause of cervical radiculopathy.
abstract: The acute onset of neck pain and arm weakness is most commonly due to cervical radiculopathy or inflammatory brachial plexopathy. Rarely, extracranial vertebral artery dissection may cause radiculopathy in the absence of brainstem ischemia. We describe a case of vertebral artery dissection presenting as cervical radiculopathy in a previously healthy 43-year-old woman who presented with proximal left arm weakness and neck pain aggravated by movement. Cervical magnetic resonance imaging (MRI) and angiography revealed dissection of the left vertebral artery with an intramural hematoma compressing the left C5 and C6 nerve roots. Antiplatelet treatment was commenced, and full power returned after 2 months. Recognition of vertebral artery dissection on cervical MRI as a possible cause of cervical radiculopathy is important to avoid interventions within the intervertebral foramen such as surgery or nerve root sleeve injection. Treatment with antithrombotic agents is important to prevent secondary ischemic events.
authors.affiliation: Department of Neurology, Royal Perth Hospital, Perth, Australia.
authors.forename: Benjamin Isaac
authors.initials: BI
authors.lastname: Silbert
authors.affiliation: SKG Radiology, St. John of God Hospital, Perth, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Khangure
authors.affiliation: Perth Neurophysiology, Perth, Australia.
authors.forename: Peter Linton
authors.initials: PL
authors.lastname: Silbert
keywords: Cervical spine; Neck pain; Radiculopathy; Vertebral artery dissection