Three cases of Spontaneous Vertebral Artery Dissection (SVAD), resulting in two cases of Wallenberg syndrome and one case of Foville syndrome in young, healthy men.
First patient, presented with sudden onset of headache, left hypoacusia and right hemiparesis, posteriorly developing gaze-evoked nystagmus and worsening right-sided weakness. Diagnosis of vertebral artery dissection and Foville Syndrome were made through clinical assessment and CT-carotid angiogram-MR angiography. Second patient, presented with four episodes of pain over left side of the nose and left eye pain over 1 month; admitted for acute facial pain without limb weakness. During admission, tingling over V1/V2 facial territory, vertigo, hypotension, uvula deviation and right lower limb numbness. CT-carotid angiogram confirmed vertebral artery with dissection. MRI revealed left lateral medullary infarct. Third patient, presented with sudden onset of left facial numbness and right upper limb weakness; 1 day after, right arm and leg hypoesthesia with hoarseness. MRA revealed dissection of left distal vertebral artery and MRI showed infarction in lower medulla oblongata.
Department of Stroke and Neurology, James Paget University Hospital NHS trust, Norwich, Great Yarmouth, UK.
Carlo
C
Canepa Raggio
Aban
A
Dasgupta
D000328:Adult; D020526:Brain Stem Infarctions / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D014854:Lateral Medullary Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology; D020217:Vertebral Artery Dissection / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*