Tuesday, 29 January 2019

Vertebral Artery Dissection

A tear in the vertebral artery, is a common cause of stroke in young people. The tear has a clot and causes a false blockage - causing an ischaemic stroke. It can happen spontaneously or after minor trauma to the neck, including yoga and chiropractice.

A recent respiratory tract infection may also predispose - making vertebral artery dissection seasonal.

There are two types:
Infarction - ischaemia of the vertebrobasillar circulation due to arterial narrowing and thromboembolism
Haemorrhagic type - presents as a SAH

They may not present with problems, because of the contralateral vessel. Acutely ruptured dissections have a high mortality, and may rebleed (mostly in the month immediately after).

Clinical Symptoms
Severe neck pain, followed later by neurological symptoms
May get a spinal cord infarction
Maybe with a headache and horners syndrome


Normally treated with anticoagulants

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588305/
https://pmj.bmj.com/content/81/956/383
http://emergencymedicineireland.com/2011/12/21/anatomy-for-emergency-medicine-2-the-vertebral-artery/

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