Vertebral artery dissection
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%.
I77.74 – Dissection of vertebral artery
230730001 – Vertebral artery dissection
Differential Diagnosis & Pitfalls