Cervical root injury caused by vertebral artery dissection

Abstract

Vertebral artery dissection is a common cause of posterior circulation strokes in young and middle-aged adults. Peripheral motor deficits have been rarely described in association with vertebral artery dissection. Peripheral motor involvement may be due to compression of the spinal nerves by an enlarged vertebral artery. It may also result from ischaemia of the anterior horn or the spinal nerves by occlusion of a spinal radicular artery that originates from the vertebral artery. Magnetic resonance imaging (MRf) and magnetic resonance angiography (MRA) offer the possibility of easy, non-invasive diagnosis of a vertebral artery dissection. Acute treatment with anticoagulants is warranted to prevent the progression of neurologic deficits due to intraluminal thrombus or artery to artery emboli. This case report describes a patient in whom vertebral artery dissection was associated with an unusual presentation with a peripheral motor deficit in the upper limb and recurrent central ischaemic neurological events.