Vertebral artery dissection

Acad Emerg Med. 1997 Oct;4(10):991-5. doi: 10.1111/j.1553-2712.1997.tb03666.x.


Vertebral artery dissections (VADs) following a variety of minor traumatic mechanisms have been previously reported. This article reports 2 cases of VAD with delayed recognition following motor vehicle collisions (MVCs). The first VAD patient developed major neurologic abnormalities 28 hours after an MVC. The second VAD patient presented with 3 weeks of neck and head pain beginning 8 weeks after an MVC and subsequent chiropractic manipulation. The anatomy and pathophysiology of VAD are reviewed. Early ED recognition prior to the onset of major neurologic deficits (e.g., paresis, dysarthria, ataxia, or altered mental status) is emphasized. An algorithm for the ED management of the entity is suggested.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Accidents, Traffic
  • Adult
  • Aneurysm, Dissecting / diagnostic imaging*
  • Aneurysm, Ruptured / diagnostic imaging*
  • Aneurysm, Ruptured / etiology
  • Cerebral Angiography
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / etiology
  • Magnetic Resonance Angiography
  • Male
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / etiology
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / injuries*