A case of severe headache attributed to vertebral artery dissection

Abstract

Background: Vertebral artery dissection (VAD) sometimes has no specific symptoms and is difficult to differentiate from other forms of headache. Case presentation: A woman in her thirties had a severe, throbbing left-sided headache. A migraine without aura was suspected and zolmitriptan was administered, which alleviated the symptoms. The woman was consequently deemed to have a migraine without aura. Despite the lack of abnormal neurological findings and showed no abnormalities on cranial computed tomography, her symptoms were not typical for migraines and showed little improvement with therapy. She therefore underwent a cranial magnetic resonance imaging (MRI) examination, which revealed VAD, for which she was transferred to the department of neurosurgery for conservative treatment. Conclusion: The possibility of vertebral artery dissection should be considered in the differential diagnosis of severe secondary headaches, and prompt diagnosis and treatment based on detailed MRI and magnetic resonance angiography examinations should be performed.

Uncommon Cause, Critical Consequence: Vertebral Artery Aneurysm Resulting in Intraventricular Hemorrhage

“…VAD leads to SAH. In Japan, in a nationwide study, it has been reported that bleeding and ischemia occur in 30.5% to 33.1% of cases [6]. The surrounding clinical anatomy of the vertebral arteries makes the treatment of an aneurysm a daunting task for the clinician as well as a neurosurgeon.…”

“…Modifying the vertebrobasilar circulation's hemodynamics could result in unpredictable longterm consequences. It is imperative to diagnose the condition as soon as possible to prevent stroke, which may occur within several days or weeks of VAD or even result in serious long-term sequelae [6]. The first investigations that are obtained frequently involve CT and CT angiography (CTA).…”

Untitled

“…Fig. 1E shows the structure of ZOT and is chemically known as (4S)-4-3-2-(dimethylamino) ethyl-1H-indol-5-yl methyl-2oxazolidinone 31 . It acts by stimulating serotonin receptors in the brain.…”