@2024 Afarand., IRAN
ISSN: 1027-1457 Scientific Journal of Forensic Medicine 2019;25(2):105-108
ISSN: 1027-1457 Scientific Journal of Forensic Medicine 2019;25(2):105-108
Case Report of Vertebral Artery Dissection Following Neck Manipulation
ARTICLE INFO
Article Type
Case SeriesAuthors
Farzi M.A. (*1)Hadavi Bavil M. (2)
Vahedi Sh. (3)
(*1) Neurology Department, Medicine Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
(2) Cardiology Department, Medicine Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
(3) Health Services Management Department, Medical Sciences & Technologies Faculty, Science & Research Branch, Islamic Azad University, Tehran, Iran
Correspondence
Address: Neurology Department, Imam Reza Hospital, Golgasht Street, Tabriz, Iran. Postal Code: 5166614756Phone: +98 (41) 33832119
Fax: +98 (41) 33342889
farzi.neuro@gmail.com
Article History
Received: September 16, 2018Accepted: May 5, 2019
ePublished: June 20, 2019
ABSTRACT
Aims
Neck arteries dissection (carotid and vertebral) is known as one of the causes of stroke which often occurs after a neck trauma. This study was a case report of a vertebral artery dissection in a young woman following a neck manipulation in order to treat a headache by a local therapist.
Patient & Methods The patient was a 27 years old woman with migraine headaches who referred to the emergency department with decreased consciousness. The results of metabolic and infectious examinations were negative, therefore brain imaging of the patient was considered. Initial CT scan had no particular finding. Therefore, MRI was performed which indicated acute infarction in the pons and cerebellum. MR angiography was performed to examine the vascular system of the brain which determined the left vertebral artery occlusion. CT angiography recognized vertebral artery dissection as the cause of vascular occlusion. Detailed examination of the patient's condition revealed that the patient experienced the neck manipulation by a local therapist before referral to the hospital.
Conclusion Neck arteries dissection as one of the causes of neurologic deficit and decrease the level of consciousness should be considered in patients with minor or severe trauma. After this diagnosis, the existence of trauma in the patient examination should be considered. Trauma may have a legal significance.
Patient & Methods The patient was a 27 years old woman with migraine headaches who referred to the emergency department with decreased consciousness. The results of metabolic and infectious examinations were negative, therefore brain imaging of the patient was considered. Initial CT scan had no particular finding. Therefore, MRI was performed which indicated acute infarction in the pons and cerebellum. MR angiography was performed to examine the vascular system of the brain which determined the left vertebral artery occlusion. CT angiography recognized vertebral artery dissection as the cause of vascular occlusion. Detailed examination of the patient's condition revealed that the patient experienced the neck manipulation by a local therapist before referral to the hospital.
Conclusion Neck arteries dissection as one of the causes of neurologic deficit and decrease the level of consciousness should be considered in patients with minor or severe trauma. After this diagnosis, the existence of trauma in the patient examination should be considered. Trauma may have a legal significance.
CITATION LINKS
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[6]CADISS trial investigators, Markus HS, Hayter E, Levi C, Feldman A, Venables G, et al. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): A randomised trial. Lancet Neurol. 2015;14(4):361-7.
[2]Jensen MB, Chacon MR, Aleu A. Cervicocerebral arterial dissection. Neurologist. 2008;14(1):5-6.
[3]Vulavala S, Cr V. An unusual case of attempted suicide by hanging. J Assoc Physicians India. 2016;64(1):154.
[4]Chokyu I, Tsumoto T, Miyamoto T, Yamaga H, Terada T, Itakura T. Traumatic bilateral common carotid artery dissection due to strangulation, a case report. Interv Neuroradiol. 2006;12(2):149-54.
[5]Shea K, Stahmer S. Carotid and vertebral arterial dissections in the emergency department. Emerg Med Pract. 2012;14(4):1-23.
[6]CADISS trial investigators, Markus HS, Hayter E, Levi C, Feldman A, Venables G, et al. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): A randomised trial. Lancet Neurol. 2015;14(4):361-7.