Extracranial vertebral artery dissection repeating distal embolism: case report
Fujimoto, K.; Shin, Y.; Iida, J-ichi.; Hirabayashi, H.; Nakase, H.; Kawaguchi, S.; Sakaki, T.; Nakagawa, H.; Kichikawa, K.
No Shinkei Geka. Neurological Surgery 33(4): 371-375
2005
ISSN/ISBN: 0301-2603 PMID: 15830544 Document Number: 587592
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.