Vertebral Artery Dissection with Cerebellar Infarction Due to Sudden Head Turning: Case Report

Abstract

A 27-year-old man upon quickly turning his head experienced sudden dizziness, unilateral limb weakness, neck pain, and paralysis. He was transported to the emergency department by ambulance. Computed tomography (CT), computed tomography angiography (CTA), and magnetic resonance imaging (MRI) of the brain identified a left vertebral artery dissection with cerebellar infarction without subarachnoid hemorrhage (SAH). The patient’s blood pressure was controlled, and he was placed on bed rest, but no surgical intervention was undertaken. A cerebral angiography performed two months after the dissection found the previously stenosed site fully patent with no further stenosis. Our case suggests that for extracranial vertebral dissection, the patient must be first checked for intracranial SAH, and in its absence, conservative treatment can be considered. Many studies have examined surgical intervention to address vertebral artery dissection; however, our case report presents a literature review regarding suitability for surgery in these patients.