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ISSN 2225-4676 (Electronic)

2015, Number 2

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Rev Cubana Neurol Neurocir 2015; 5 (2)

Cerebellar infarct due to extracranial vertebral artery dissection caused by sudden neck rotation: a case report

López AJ, Rodríguez CAB, Sosa ÁLM, González AG, Montalvo ML, Barrios FPJ, González PF

Language: Spanish
References: 13
Page: 146-150
PDF size: 411.42 Kb.


ABSTRACT

Introduction: Carotid and vertebral arteries dissection represents a rare cause of stroke, and it´s reported mainly in young and middle age patients. This case shows the variable presentation of vertebral artery dissection and some current management problems.
Clinical case: 42 year old male patient who began in the morning after a sudden head rotation with dizziness that improved with decubitus and were exacerbated with the changes of position. Neurological examination revealed focal signs as ataxic gait, dysmetria, dysdiadochokinesis, right muscle hypotonia, and paresis of right abducens muscle due cranial nerve VI lesion. Magnetic resonance images showed an infarct in right cerebellar hemisphere and angioCT scan showed right vertebral artery dissection. It was decided hospitalization in neurology service with diagnosis of ischemic stroke of posterior territory. Then the patient received treatment with aspirin (125 mg/day). After 10 days of evolution he began with improvement of the neurological focal symptoms, and later with disappearance of neurological signs.
Conclusions: This case reaffirms the need to consider this entity as cause of ischemic stroke in young adults. The attribution of symptoms to minor conditions and symptoms variability teach the value of capacity for history collection and examination, anatomic correlation and chronologic approach. Also, is fundamental a rapid diagnosis and the early beginning of therapy, that can potentially change the evolution of this entity.


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