Sqalli Houssaini Adam, Lembarki Sarah, Chait Fatima, Jiddane Mohamed, Touarsa Firdaous
Neuroradiology department, Hospital of specialities, Ibn Sina university hospital center, Rabat, Morocco.
Radiol Case Rep. 2024 Dec 20;20(3):1447-1451. doi: 10.1016/j.radcr.2024.11.095. eCollection 2025 Mar.
Bilateral vertebral artery dissections account for only 8% of all vertebral artery dissections and cause just 2% of all ischemic strokes. They can occur spontaneously, even without any triggering factor. Classical clinical findings, such as headache or neck pain, may be absent, particularly in the context of a stroke. Imaging is the modality of choice for diagnosis and includes ultrasound, catheter-based DSA, computed tomography angiography, and MRA. The main differential diagnoses include atherosclerotic plaques, hypoplastic vertebral artery, and vertebral artery fenestration. The primary treatment involves antithrombotic therapy. We report the case of a 57-year-old woman with no history of cardiovascular disease who presented to the emergency department with hemibody weakness and slurred speech. Magnetic resonance imaging on admission revealed multiple hypoperfusion-related ischemic areas involving the vertebrobasilar artery territory and findings suggestive of bilateral vertebral artery dissection.
双侧椎动脉夹层仅占所有椎动脉夹层的8%，且仅导致所有缺血性卒中的2%。它们可自发发生，甚至无任何触发因素。典型的临床症状，如头痛或颈部疼痛，可能不存在，尤其是在卒中的情况下。影像学检查是诊断的首选方式，包括超声、导管血管造影、计算机断层血管造影和磁共振血管造影。主要的鉴别诊断包括动脉粥样硬化斑块、椎动脉发育不全和椎动脉开窗。主要治疗方法为抗血栓治疗。我们报告了一例57岁无心血管疾病史的女性患者，她因半身无力和言语不清就诊于急诊科。入院时的磁共振成像显示多个与灌注不足相关的缺血区域，累及椎基底动脉供血区，且发现提示双侧椎动脉夹层。
