Neurological Disorders: Vertebral Artery Dissection

Introduction

Vertebral Artery Dissection is a condition where damage takes place to the vertebral artery, one of the pair of arteries that travel upwards in the back aspect of the neck and supply the brain.

Brain has two types of blood supply - an anterior and posterior type of circulations. The anterior blood supply is by a pair of internal carotid arteries and the posterior by pair of vertebral arteries.

The vertebral arteries unite to form a single basilar artery and this posterior circulation together is called a vertebrobasilar circulation. The dissection can happen in the basilar artery too.

Aterial dissections are common causes of stroke or mini stroke in young adults.

For a detailed discussion on what causes the dissection, its diagnosis & treatment etc please click for the article on Carotid Artery Dissection .

With regard to the diagnosis, in that article it is focused on the carotid artery related investigations and in pace of them in this case we test for vertebral artery involvement. But the investigations are generally the same.

With regard to the clinical manifestations of the dissection involving the vertebral artery you will not see the aphasic speech difficulties rather there may be dysarthria type of speech difficulties. Facial & limb manifestations may occur to similar to carotid artery dissection. With vertebral artery involvement there may be additional manifestations like vertigo (spinning sensation), nausea, vomiting, double vision, eye lid drooping etc.

The management of dissection of vertebral artery is nearly similar to that of carotid artery dissection discussed in that article and depending upon the severity of the dissection injury it may involve using antiplatelet agents like aspirin or clopidogrel, blood thinners like warfarin, dabigatran, heparin etc. Once the clot dissolves the antiplatelet agent or the blood thinner can be discontinued.

A neurologist is commonly involved in the management of patients with dissection of the vertebral artery.



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