Occlusion of the Vertebral Artery Secondary to Dissection of the Subclavian Artery-Case Report-

Abstract

A 34-year-old man presented with occlusion of the left vertebral artery (VA) secondary to dissection of the left subclavian artery manifesting as vertigo, nausea, vomiting, and neck pain. On admission, he was alert with left limb and truncal ataxia. Magnetic resonance (MR) imaging and MR angiography showed left cerebellar infarction and occlusion of the left VA. Conventional angiography and threedimensional computed tomography (3D-CT) angiography showed stenosis with thrombosed pseudolumen of the left subclavian artery, and occlusion of the left VA. Presumably the idiopathic dissection of the left subclavian artery had reached the orifice of the left VA, and an embolism from the dissection had caused occlusion of the VA, leading to cerebellar infarction. After one month, he was discharged without severe neurological deficits. Idiopathic dissection of the subclavian artery is very rare. 3D-CT angiography is very useful for the diagnosis of arterial dissection.

A new model of thromboembolic stroke in the posterior circulation of the rat

“…Due to the vital importance of the brainstem, even small lesions in this region can produce pronounced neurological deficits, whereas relatively large cerebellar lesions may be well tolerated initially (Iwamuro et al, 2005;Jensen and St Louis, 2005). Depending on the ratio of vessel diameter to embolus size it can be expected that the variability in size and location of the resulting stroke is greater in thromboembolic models than in models of standardized clipping, coagulation, or occlusion (Mcauley, 1995).…”

Conservative Management in a Young Woman Affected by Isolated Left Subclavian Artery Dissection

“…Claudicatio 6) of upper limb, up to ischemic phenomena are reported, even if the collateral circulation of the shoulder may provide a sufficient compensation of the arm. 3) The involvement of VA determines "posterior symptoms" such as nausea, dizziness and vomiting, 9) up to stroke, 10) while a dissection towards the vessels of the arm or the aorta can result in back pain radiating to the precordium, 2) chest pain, 3) neck pain, 11) dullness 8) or claudicatio 6) of upper limb, up to ischemic phenomena. 12) Physical examination detects typically different blood pressure between arms and/or signs of unilateral upper limb ischemia.…”

Idiopathic dissection from left subclavian artery to brachial artery: Spontaneous repair with conservative management

“…SA dissection has been reported with anomalies of the aortic arch and in an anatomically normal arch following trauma or iatrogenic injury during catheterization. Patients have been reported to present with chest and back pain and sometimes neurological symptoms [1][2][3]. * Corresponding author.…”