Central respiratory dysfunction following vertebral artery dissection

Abstract

Vertebral artery dissection (VAD) is a major cause of cerebral ischemia in young patients.1 Precipitating events associated with a hyperextension of the neck are common in cervical artery dissections2 and may damage the arterial vessel wall due to mechanical stretching. Typical initial symptoms are neck pain and headache, which is most often in the occipital area. The time interval between first symptoms and the onset of stroke varies from a few minutes to several weeks.3 The combination of medullary and cervical spinal cord ischemia due to VAD is uncommon4,5 and a central respiratory failure complicating VAD, even weeks after initial symptoms, is an unusual finding recently observed. A 42-year-old carpenter was admitted 2 hours after onset of nausea and unsteadiness of gait. He reported neck pain for 1 week after having painted …