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Archivos de Medicina de Urgencia de México

2025, Number 2-3

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Arch Med Urg Mex 2025; 17 (2-3)

Dissection of the right vertebral artery associated with areas of bilateral cerebellar ischemia

López-Lucero LY, Abad-García A

Language: Spanish
References: 15
Page: 158-163
PDF size: 310.84 Kb.


ABSTRACT

Introduction: Vertebral artery dissection (VAD) is an uncommon but important cause of posterior circulation ischemia, especially in young adults without atherosclerotic risk factors. It results from an intimal tear that allows blood to enter the arterial wall, forming an intramural hematoma that may cause stenosis, occlusion, or distal embolization.
Objective: to present a case of bilateral vertebral artery dissection following physical exercise, associated with bilateral cerebellar and thalamic ischemia.
Material and methods: observational case report. Clinical evolution, laboratory findings, and neuroimaging studies were documented in a 42-year-old woman admitted after sudden severe headache, syncope, and loss of consciousness. Diagnosis was confirmed by CT angiography showing dissection of the right vertebral artery (V3–V4) and left vertebral artery (V4), with bilateral cerebellar and thalamic ischemic areas.
Discussion: VAD may present with nonspecific symptoms such as headache or vertigo, which often delay diagnosis. In this patient, intense weight-lifting activity preceded the event, suggesting mechanical neck stress as a triggering factor. Bilateral involvement is rare and carries a higher risk of vertebrobasilar compromise and poor neurological outcome. Advanced vascular imaging is essential for confirmation.
Conclusion: Early clinical suspicion and prompt imaging are crucial for the diagnosis and management of vertebral artery dissection. Awareness of this condition in young adults without vascular risk factors can prevent severe neurological complications.


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