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:: Volume 25, Issue 2 (2019) ::
Iran J Forensic Med 2019, 25(2): 1-4 Back to browse issues page
Case Report of Vertebral Artery Dissection Following Neck Manipulation
M.A. Farzi *1, M. Hadavi bavil2, Sh. Vahedi3
1- Neurology Department, Medicine Faculty, Tabriz University of Medical Sciences, Tabriz, Iran , Farzi.neuro@gmail.com
2- Cardiology Department, Medicine Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
3- Health Services Management Department, Medical Sciences & Technologies Faculty, Science & Research Branch, Islamic Azad University, Tehran, Iran
Abstract:   (62 Views)

Aim(s): Neck arteries dissection (carotid and vertebral) is known as one of the causes of stroke which often occurs after a neck trauma. This study was a case report of a vertebral artery dissection in a young woman following a neck manipulation in order to treat a headache by a local therapist.
Patient Information: The patient was a 27 years old woman with migraine headaches who referred to the emergency department with decreased consciousness. The results of metabolic and infectious examinations were negative, therefore brain imaging of the patient was considered.  Initial CT scan had no particular finding. Therefore, MRI was performed which indicated acute infarction in the pons and cerebellum. MR angiography was performed to examine the vascular system of the brain which determined the left vertebral artery occlusion. CT angiography recognized vertebral artery dissection as the cause of vascular occlusion. Detailed examination of the patient's condition revealed that the patient experienced the neck manipulation by a local therapist before referral to the hospital.
Conclusion: Neck arteries dissection as one of the causes of neurologic deficit and decrease the level of consciousness should be considered in patients with minor or severe trauma. After this diagnosis, the existence of trauma in the patient examination should be considered. Trauma may have a legal significance.

 

Keywords: Dissection, Vertebral Artery, Neck, Trauma
Full-Text [PDF 412 kb]   (22 Downloads)    
Article Type: Case Report | Subject: Legal Neurology
Received: 2018/09/16 | Accepted: 2019/05/5 | Published: 2019/06/20
* Corresponding Author Address: Neurology Department, Imam Reza Hospital, Golgasht Street, Tabriz, Iran.
References
1. 1- Park KW, Park JS, Hwang SC, Im SB, Shin WH, Kim BT. Vertebral artery dissection: Natural history, clinical features and therapeutic considerations. J Korean Neurosurg Soc. 2008;44(3):109-15. [Link] [DOI:10.3340/jkns.2008.44.3.109]
2. Jensen MB, Chacon MR, Aleu A. Cervicocerebral arterial dissection. Neurologist. 2008;14(1):5-6. [Link] [DOI:10.1097/NRL.0b013e3180d0a380]
3. Vulavala S, Cr V. An unusual case of attempted suicide by hanging. J Assoc Physicians India. 2016;64(1):154. [Link]
4. Chokyu I, Tsumoto T, Miyamoto T, Yamaga H, Terada T, Itakura T. Traumatic bilateral common carotid artery dissection due to strangulation, a case report. Interv Neuroradiol. 2006;12(2):149-54. [Link] [DOI:10.1177/159101990601200209]
5. Shea K, Stahmer S. Carotid and vertebral arterial dissections in the emergency department. Emerg Med Pract. 2012;14(4):1-23. [Link]
6. CADISS trial investigators, Markus HS, Hayter E, Levi C, Feldman A, Venables G, et al. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): A randomised trial. Lancet Neurol. 2015;14(4):361-7. [Link] [DOI:10.1016/S1474-4422(15)70018-9]
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Farzi M, Hadavi bavil M, Vahedi S. Case Report of Vertebral Artery Dissection Following Neck Manipulation. Iran J Forensic Med. 2019; 25 (2) :1-4
URL: http://sjfm.ir/article-1-970-en.html


Volume 25, Issue 2 (2019) Back to browse issues page
مجله پزشکی قانونی ایران Iranian Journal of Forensic Medicine
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