Vertebral artery dissection presenting as a Brown-Sequard syndrome: a case report
IntroductionVertebral artery dissection has become increasingly recognized as an important cause of stroke. It usually presents with posterior headache or neck pain followed within hours or days by signs of posterior circulation stroke. The clinical presentation of a brown-sequard syndrome with a vertebral artery dissection has been reported only once previously.Case presentationA healthy 35 year male presented with acute left sided weakness. He had experienced left sided posterior neck pain since travel four weeks previously. Physical examination was consistent with a left brown-sequard syndrome. Magnetic resonance angiography showed evidence of left vertebral artery dissection. He improved on anticoagulation.
Conclusion:
We report an unusual presentation of a relatively uncommon condition. The diagnosis should be considered early in young patients with stroke like symptoms or unexplained neck pain because missing a dissection can be costly.