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Bilateral vertebral artery dissection extending to the left posterior cerebral artery: A case report
Intracranial artery dissection accounts for a small percentage (1%-2%) of all ischemic strokes. Vertebral artery dissection sometimes extends to the basilar artery but very rarely to the posterior cerebral artery. We report a case of bilateral vertebral artery dissection extending to the left poster...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9989296/ https://www.ncbi.nlm.nih.gov/pubmed/36895896 http://dx.doi.org/10.1016/j.radcr.2023.01.099 |
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author | Morishita, Masahiro Shindo, Koichiro Yoshihara, Ryunosuke Ishikawa, Kohei Nomura, Ryota Endo, Hideki Oka, Koji Nakamura, Hirohiko |
author_facet | Morishita, Masahiro Shindo, Koichiro Yoshihara, Ryunosuke Ishikawa, Kohei Nomura, Ryota Endo, Hideki Oka, Koji Nakamura, Hirohiko |
author_sort | Morishita, Masahiro |
collection | PubMed |
description | Intracranial artery dissection accounts for a small percentage (1%-2%) of all ischemic strokes. Vertebral artery dissection sometimes extends to the basilar artery but very rarely to the posterior cerebral artery. We report a case of bilateral vertebral artery dissection extending to the left posterior cerebral artery with the characteristic distribution of intramural hematoma. A 51-year-old woman presented with right hemiparesis and dysarthria 3 days after sudden neck pain. Magnetic resonance imaging on admission revealed infarcts in the left thalamus and temporo-occipital lobe and findings suggestive of bilateral vertebral artery dissection. No infarct was detected in the brainstem. The patient was treated conservatively. Initially, we suspected that infarction in the left posterior cerebral artery territory had been caused by artery-to-artery embolism from the dissected vertebral arteries. However, T1-weighted imaging on day 15 of admission revealed intramural hematoma extending from the left vertebral artery to the left posterior cerebral artery. Therefore, we diagnosed bilateral vertebral artery dissection extending to the basilar artery and the left posterior cerebral artery. The patient's symptoms subsequently improved with conservative treatment, and she was discharged with a modified Rankin Scale score of 1 on day 62 of admission. In this case, intramural hematoma of the basilar artery was found in the anterior vessel wall. Brainstem infarction is less likely when intramural hematoma is located in the anterior vessel wall of the basilar artery in vertebrobasilar artery dissection. T1-weighted imaging is useful for the diagnosis of this rare condition and can predict potentially impaired branches and possible symptoms. |
format | Online Article Text |
id | pubmed-9989296 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-99892962023-03-08 Bilateral vertebral artery dissection extending to the left posterior cerebral artery: A case report Morishita, Masahiro Shindo, Koichiro Yoshihara, Ryunosuke Ishikawa, Kohei Nomura, Ryota Endo, Hideki Oka, Koji Nakamura, Hirohiko Radiol Case Rep Case Report Intracranial artery dissection accounts for a small percentage (1%-2%) of all ischemic strokes. Vertebral artery dissection sometimes extends to the basilar artery but very rarely to the posterior cerebral artery. We report a case of bilateral vertebral artery dissection extending to the left posterior cerebral artery with the characteristic distribution of intramural hematoma. A 51-year-old woman presented with right hemiparesis and dysarthria 3 days after sudden neck pain. Magnetic resonance imaging on admission revealed infarcts in the left thalamus and temporo-occipital lobe and findings suggestive of bilateral vertebral artery dissection. No infarct was detected in the brainstem. The patient was treated conservatively. Initially, we suspected that infarction in the left posterior cerebral artery territory had been caused by artery-to-artery embolism from the dissected vertebral arteries. However, T1-weighted imaging on day 15 of admission revealed intramural hematoma extending from the left vertebral artery to the left posterior cerebral artery. Therefore, we diagnosed bilateral vertebral artery dissection extending to the basilar artery and the left posterior cerebral artery. The patient's symptoms subsequently improved with conservative treatment, and she was discharged with a modified Rankin Scale score of 1 on day 62 of admission. In this case, intramural hematoma of the basilar artery was found in the anterior vessel wall. Brainstem infarction is less likely when intramural hematoma is located in the anterior vessel wall of the basilar artery in vertebrobasilar artery dissection. T1-weighted imaging is useful for the diagnosis of this rare condition and can predict potentially impaired branches and possible symptoms. Elsevier 2023-02-27 /pmc/articles/PMC9989296/ /pubmed/36895896 http://dx.doi.org/10.1016/j.radcr.2023.01.099 Text en © 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Morishita, Masahiro Shindo, Koichiro Yoshihara, Ryunosuke Ishikawa, Kohei Nomura, Ryota Endo, Hideki Oka, Koji Nakamura, Hirohiko Bilateral vertebral artery dissection extending to the left posterior cerebral artery: A case report |
title | Bilateral vertebral artery dissection extending to the left posterior cerebral artery: A case report |
title_full | Bilateral vertebral artery dissection extending to the left posterior cerebral artery: A case report |
title_fullStr | Bilateral vertebral artery dissection extending to the left posterior cerebral artery: A case report |
title_full_unstemmed | Bilateral vertebral artery dissection extending to the left posterior cerebral artery: A case report |
title_short | Bilateral vertebral artery dissection extending to the left posterior cerebral artery: A case report |
title_sort | bilateral vertebral artery dissection extending to the left posterior cerebral artery: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9989296/ https://www.ncbi.nlm.nih.gov/pubmed/36895896 http://dx.doi.org/10.1016/j.radcr.2023.01.099 |
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