Emergency: requires immediate attention
Vertebral artery dissection
Alerts and Notices
Synopsis

Early symptoms can include occipital headache and neck pain. Focal neurological deficits related to vertebral artery territory ischemia can occur initially or after a latent period (usually within 3-7 days). These symptoms include ipsilateral facial numbness, contralateral body numbness, ataxia, nystagmus, vertigo, nausea / vomiting, dysarthria, dysphagia, hiccups, or ipsilateral Horner syndrome.
Prognosis is good overall but primarily hinges on the severity of the resulting ischemic event. If the VAD is complicated by thromboembolism, symptoms can include cortical vision loss and altered mental status. In acute cases, especially when accompanied by intracranial extension, mortality can approach 10%.
Codes
ICD10CM:I77.74 – Dissection of vertebral artery
SNOMEDCT:
230730001 – Vertebral artery dissection
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Brainstem or cerebellar infarction
- Brainstem or cerebellar hemorrhage
- Brainstem or cerebellar glioma
- Subarachnoid hemorrhage
- Cerebral aneurysm
- Central pontine myelinolysis
- Cerebellitis (see acute cerebellar ataxia)
- Vasculitis
- Migraine headache
- Cervical spine disease
- Reversible posterior leukoencephalopathy
- Cerebellar ataxia
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References
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Last Reviewed:04/08/2018
Last Updated:04/08/2018
Last Updated:04/08/2018