Fatal bilateral vertebral artery dissection in a patient with cystic medial necrosis

doi:10.1016/0303-8467(91)90095-7

Clinical Neurology and Neurosurgery

Volume 93, Issue 4, 1991, Pages 309-311

https://doi.org/10.1016/0303-8467(91)90095-7 Get rights and content

Abstract

A 38-year-old man experienced severe neck pain while playing badminton. This was followed by symptoms of vertebrobasilar ischaemia, seizure and coma. Autopsy showed bilateral vertebral artery dissection and cystic medial necrosis.

References (14)

R.G. Hart et al.
Dissections
Stroke
(1985)
R.G. Hart
Vertebral artery dissection
Neurology
(1988)
S.J. Phillips et al.
Pure motor stroke due to vertebral artery dissection
Can J Neurol Sci
(1989)
J.W. Dunne et al.
Dissecting aneurysms of the vertebral arteries following cervical manipulation: a case report
J Neurol Neurosurg Psychiatry
(1987)
M.B. Katirji et al.
Stroke due to vertebral artery injury
Arch Neurol
(1985)
D Leys et al.
Bilateral spontaneous dissection of extracranial vertebral arteries
J Neurol
(1987)
W Pryse-Phillips
Infarction of the medulla and cervical cord after fitness exercises
Stroke
(1989)

There are more references available in the full text version of this article.

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Case reportFatal bilateral vertebral artery dissection in a patient with cystic medial necrosis

Abstract

Dissections

Stroke

Vertebral artery dissection

Neurology

Pure motor stroke due to vertebral artery dissection

Can J Neurol Sci

Dissecting aneurysms of the vertebral arteries following cervical manipulation: a case report

J Neurol Neurosurg Psychiatry

Stroke due to vertebral artery injury

Arch Neurol

Bilateral spontaneous dissection of extracranial vertebral arteries

J Neurol

Infarction of the medulla and cervical cord after fitness exercises

Stroke

Case report
Fatal bilateral vertebral artery dissection in a patient with cystic medial necrosis