A Cervical Spine Manipulation-associated Dissection of Basilar Artery – a Case Report

Czech version

Authors: M. Tinková ¹; J. Kasík ¹; J. Lacman ²
Authors‘ workplace: ÚVN Praha Neurologické oddělení ¹; ÚVN Praha Radiodiagnostické oddělení, LF UK v Hradci Králové ²
Published in: Cesk Slov Neurol N 2011; 74/107(3): 348-352
Category: Case Report

Overview

The authors present the case of a 37-year-old female who presented with severe acute dizziness with subsequent neurological deficit. A diagnosis of basilar artery occlusion was made and successfully treated with acute stenting.Vertebrobasilar dissection after manipulation of the cervical spine is a rare complication of this therapeutic modality. The exact incidence of vertebrobasilar dissection and subsequent stroke is not known. The significant worsening of neck pain and the onset of neurological symptoms after the manipulation indicates urgent neurological examination. CT angiography (CTA) is the most available imaging method in the diagnostics of basilar artery occlusion. Diffusion-weighted MRI (DWI) in combination with perfusion- weighted MRI (PWI) has proved wisely useful in the selection of patients suitable for acute therapy, should a mismatch between these procedures suggest viable penumbral tissue. A diagnosis of occlusion of the basilar artery is a strong indication for urgent endovascular intervention.

Key words:
dissection of vertebral artery – Wallenberg syndrome – thrombosis of basilar artery

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