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Spontaneous Bilateral Dissection of the Vertebral Artery: A Case Report

Spontaneous dissection of the vertebral artery refers to cases that do not involve significant blunt or penetrating trauma as a precipitating factor. However, cases of spontaneous dissection of the vertebral artery do have a history of trivial or minor injury involving some degree of cervical distor...

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Autores principales: Almuaigel, Mohammed F, Althwanay, Aldanah, Alamri, Abdullah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440263/
https://www.ncbi.nlm.nih.gov/pubmed/32839679
http://dx.doi.org/10.7759/cureus.9310
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author Almuaigel, Mohammed F
Althwanay, Aldanah
Alamri, Abdullah
author_facet Almuaigel, Mohammed F
Althwanay, Aldanah
Alamri, Abdullah
author_sort Almuaigel, Mohammed F
collection PubMed
description Spontaneous dissection of the vertebral artery refers to cases that do not involve significant blunt or penetrating trauma as a precipitating factor. However, cases of spontaneous dissection of the vertebral artery do have a history of trivial or minor injury involving some degree of cervical distortion such as chiropractic neck manipulation, as the extreme hyperextension and/or rotation of the neck may create areas of stretch and lead to intimal or adventitial tears in the vertebral artery causing dissection. It is a relatively rare, potentially disabling and sometimes an under-diagnosed cause of stroke. It accounts for 2% of all ischemic strokes and 7% of the cases are bilateral. Herein we present a case of bilateral vertebral artery dissection complicated by basilar artery stroke in a young male patient following chiropractic manipulation of the neck. Neuroimaging modalities upon presentation confirmed the diagnosis. Antiplatelets were administered, and a great clinical outcome after three months was achieved. This report demonstrates the potential hazards associated with neck trauma, including chiropractic manipulation, as it is under reported in Saudi Arabia.
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spelling pubmed-74402632020-08-23 Spontaneous Bilateral Dissection of the Vertebral Artery: A Case Report Almuaigel, Mohammed F Althwanay, Aldanah Alamri, Abdullah Cureus Emergency Medicine Spontaneous dissection of the vertebral artery refers to cases that do not involve significant blunt or penetrating trauma as a precipitating factor. However, cases of spontaneous dissection of the vertebral artery do have a history of trivial or minor injury involving some degree of cervical distortion such as chiropractic neck manipulation, as the extreme hyperextension and/or rotation of the neck may create areas of stretch and lead to intimal or adventitial tears in the vertebral artery causing dissection. It is a relatively rare, potentially disabling and sometimes an under-diagnosed cause of stroke. It accounts for 2% of all ischemic strokes and 7% of the cases are bilateral. Herein we present a case of bilateral vertebral artery dissection complicated by basilar artery stroke in a young male patient following chiropractic manipulation of the neck. Neuroimaging modalities upon presentation confirmed the diagnosis. Antiplatelets were administered, and a great clinical outcome after three months was achieved. This report demonstrates the potential hazards associated with neck trauma, including chiropractic manipulation, as it is under reported in Saudi Arabia. Cureus 2020-07-21 /pmc/articles/PMC7440263/ /pubmed/32839679 http://dx.doi.org/10.7759/cureus.9310 Text en Copyright © 2020, Almuaigel et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Almuaigel, Mohammed F
Althwanay, Aldanah
Alamri, Abdullah
Spontaneous Bilateral Dissection of the Vertebral Artery: A Case Report
title Spontaneous Bilateral Dissection of the Vertebral Artery: A Case Report
title_full Spontaneous Bilateral Dissection of the Vertebral Artery: A Case Report
title_fullStr Spontaneous Bilateral Dissection of the Vertebral Artery: A Case Report
title_full_unstemmed Spontaneous Bilateral Dissection of the Vertebral Artery: A Case Report
title_short Spontaneous Bilateral Dissection of the Vertebral Artery: A Case Report
title_sort spontaneous bilateral dissection of the vertebral artery: a case report
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440263/
https://www.ncbi.nlm.nih.gov/pubmed/32839679
http://dx.doi.org/10.7759/cureus.9310
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