Spontaneous Subclavian Artery Dissection Presenting as Posterior Circulation Infarction

Background Spontaneous subclavian artery dissection (SAD) is rare. Moreover, there are very few case reports which document spontaneous SAD accompanied by symptomatic neurological deficits related with ischemic stroke. Case Report A 71-year-old man without any reported history of trauma presented wi...

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Main Authors: Kipyoung Jeon, Hyun-Ji Cho
Format: Article
Language:English
Published: The Korean Neurocritical Care Society 2017-12-01
Series:Journal of Neurocritical Care
Subjects:
Online Access:http://www.e-jnc.org/upload/pdf/jnc-170013.pdf
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author Kipyoung Jeon
Hyun-Ji Cho
author_facet Kipyoung Jeon
Hyun-Ji Cho
author_sort Kipyoung Jeon
collection DOAJ
description Background Spontaneous subclavian artery dissection (SAD) is rare. Moreover, there are very few case reports which document spontaneous SAD accompanied by symptomatic neurological deficits related with ischemic stroke. Case Report A 71-year-old man without any reported history of trauma presented with left facial hypesthesia, left arm ataxia and gait disturbance, subsequently diagnosed as posterior circulation infarction affecting medulla and cerebellum. The computed tomography angiography revealed spontaneous left SAD with left vertebral artery occlusion, atherosclerotic plaque surrounding the origin of left subclavian artery and normal aortic vasculature. His neurological status did not deteriorate further after dual anti-platelet therapy, and intravenous hydration with volume expander were applied. Conclusions This is an unusual case of spontaneous SAD with lateral medullary infarction as well as cerebellar infarction. Although spontaneous SAD is a distinctly rare disease entity, it should be considered in the differential diagnosis when multiple posterior circulation infarctions are observed.
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spelling doaj.art-ec9cffb0a2bd4b939cdb205e3712dacd2022-12-21T20:25:44ZengThe Korean Neurocritical Care SocietyJournal of Neurocritical Care2005-03482508-13492017-12-0110211612110.18700/jnc.170013263Spontaneous Subclavian Artery Dissection Presenting as Posterior Circulation InfarctionKipyoung Jeon0Hyun-Ji Cho1 Department of Neurology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, KoreaBackground Spontaneous subclavian artery dissection (SAD) is rare. Moreover, there are very few case reports which document spontaneous SAD accompanied by symptomatic neurological deficits related with ischemic stroke. Case Report A 71-year-old man without any reported history of trauma presented with left facial hypesthesia, left arm ataxia and gait disturbance, subsequently diagnosed as posterior circulation infarction affecting medulla and cerebellum. The computed tomography angiography revealed spontaneous left SAD with left vertebral artery occlusion, atherosclerotic plaque surrounding the origin of left subclavian artery and normal aortic vasculature. His neurological status did not deteriorate further after dual anti-platelet therapy, and intravenous hydration with volume expander were applied. Conclusions This is an unusual case of spontaneous SAD with lateral medullary infarction as well as cerebellar infarction. Although spontaneous SAD is a distinctly rare disease entity, it should be considered in the differential diagnosis when multiple posterior circulation infarctions are observed.http://www.e-jnc.org/upload/pdf/jnc-170013.pdfSubclavian arteryDissectionCerebral infarction
spellingShingle Kipyoung Jeon
Hyun-Ji Cho
Spontaneous Subclavian Artery Dissection Presenting as Posterior Circulation Infarction
Journal of Neurocritical Care
Subclavian artery
Dissection
Cerebral infarction
title Spontaneous Subclavian Artery Dissection Presenting as Posterior Circulation Infarction
title_full Spontaneous Subclavian Artery Dissection Presenting as Posterior Circulation Infarction
title_fullStr Spontaneous Subclavian Artery Dissection Presenting as Posterior Circulation Infarction
title_full_unstemmed Spontaneous Subclavian Artery Dissection Presenting as Posterior Circulation Infarction
title_short Spontaneous Subclavian Artery Dissection Presenting as Posterior Circulation Infarction
title_sort spontaneous subclavian artery dissection presenting as posterior circulation infarction
topic Subclavian artery
Dissection
Cerebral infarction
url http://www.e-jnc.org/upload/pdf/jnc-170013.pdf
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