Nguyen Thuy Hao, Akhtar Muhammad Ali, Chaudhary Pradip, Subedi Bhawuk, Marcus Huda
Internal Medicine, Michigan State University, Flint, USA.
Internal Medicine, Hurley Medical Center, Flint, USA.
Cureus. 2025 Mar 28;17(3):e81372. doi: 10.7759/cureus.81372. eCollection 2025 Mar.
Vertebral artery dissection (VAD) is a notable cause of stroke, especially in young individuals. This case reports the diagnosis of ischemic stroke in the right cerebellar hemisphere and posterior medulla on the right side, secondary to dissection of the V3 segment of the right vertebral artery of a 24-year-old female. She presented with the chief complaint of vertigo and double vision for a duration of one day. Her initial symptoms presented one day before, which were excruciating pain in her right ear and subsequent temporary hearing loss in the same ear. The patient had significant nystagmus. Computed tomography scan of the head and computed tomography angiography were negative for acute findings. Magnetic resonance imaging of the head with contrast was done, indicating an acute/subacute ischemic stroke in the right cerebellar hemisphere and posterior medulla on the right side. MRI of the neck showed occlusive dissection of the V3 segment of the right vertebral artery. Dual antiplatelet therapy was initiated with aspirin and Brilinta. This case highlights the importance of recognizing and diagnosing VAD in a timely manner, especially in patients with atypical symptoms.
椎动脉夹层（VAD）是中风的一个显著原因，尤其是在年轻人中。本病例报告了一名24岁女性因右侧椎动脉V3段夹层继发右侧小脑半球和右侧延髓后部缺血性中风的诊断情况。她的主要诉求是眩晕和复视，持续了一天。她的初始症状出现在一天前，先是右耳剧痛，随后同一耳朵出现暂时性听力丧失。患者有明显的眼球震颤。头部计算机断层扫描和计算机断层血管造影未发现急性病变。进行了头部磁共振成像增强检查，显示右侧小脑半球和右侧延髓后部有急性/亚急性缺血性中风。颈部磁共振成像显示右侧椎动脉V3段闭塞性夹层。开始使用阿司匹林和替格瑞洛进行双联抗血小板治疗。本病例强调了及时识别和诊断VAD的重要性，尤其是对于有非典型症状的患者。
