Bilateral vertebral artery dissection complicated by posterior circulation stroke in a young man

Abstract

Introduction: Vertebral artery dissection (VAD) is a common cause of stroke in young and mid-aged adults without predisposing risk factors for vascular disease. It can be induced by a particular head or neck posture; its early signs often include headache and neck pain. Improved imaging techniques can be used to detect VAD, whose current treatment options are limited. Patient concerns: The patient presented with neck and shoulder pain for a week after sleeping against the wall with cervical proneness for 1 night. He had sudden headache, slurred speech, and left side weakness for 1.5 hours on admission. Diagnosis: The patient had VAD complicated by posterior circulation stroke. Interventions: Acute stroke was treated with intravenous thrombolytic therapy. Then, the patient was administered follow-up anticoagulants. Outcomes: The patient's condition improved after thrombolytic therapy. He recovered well, with no recurrence during a 4-year follow-up. Conclusion: VAD should be taken into consideration in differential diagnosis of posterior circulation stroke or transient ischemic attack in young patients. Intravenous thrombolytic therapy may be safe and effective for stroke-complicated cases. This case report demonstrates that expanded diagnostic protocol for acute ischemic stroke assures rapid and correct diagnosis.

Impact of Different Isokinetic Movement Patterns on Shoulder Rehabilitation Outcome

“…Shoulder pain is one of the most common complaints of the musculoskeletal system, with a lifetime prevalence estimated between 7 and 10%, and is most frequently caused by impingement syndromes and rotator cuff tears [ 1 , 2 ]. Other causes for shoulder pain should also be considered in the differential diagnosis [ 3 ], such as osteoarthritis, nerve irritation [ 4 ], instability, Parsonage–Turner syndrome [ 5 , 6 ], tumors, and conditions of inner organs [ 7 , 8 , 9 , 10 ], rheumatic diseases [ 11 ], alterations of local blood vessels [ 12 ], trauma, and osteonecrosis [ 13 ].…”