IMAGES IN NEUROLOGY
Spontaneous subclavian artery dissection in a young woman with migraine: an unusual etiology of stroke
Dissecção espontânea de artéria subclávia em uma jovem migranosa: etiologia incomum de acidente vascular cerebral
Artur Furlaneto Fernandes; Marcos Christiano Lange; Elcio Juliato Piovesan; Laura Nicoleti Zamproni; Francisco M. Branco Germiniani; Viviane F. Zétola
Neurology Emergency Unit, Neurology Division, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba PR, Brazil
Correspondence Correspondence: Marcos Christiano Lange Rua General Carneiro 181 / 4º andar 80060-900 Curitiba PR - Brasil E-mail: lange@ufpr.br
A 31-year-old woman with a previous history of migraine without aura was admitted to the emergency room complaining of an occipital headache with sudden onset, accompanied by vomiting and gait disturbance, which had started seven days prior to her admission. Neurological examination showed scanning speech, right homonymous hemianopsia, bilateral Babinski's sign, head titubation and axial and appendicular ataxia. MRI showed bilateral infarction of the cerebellum and occipital lobes and of the left thalamus (Figure A, B). Digital angiography revealed a dissection of the left subclavian artery with a thrombus in the left vertebral artery (segment V4) (Figure C, D).
Subclavian artery dissection is a rare entity and previous reports associate it with coexisting aortic abnormalities, trauma or catheterization procedures.
Received 13 January 2010
Accepted 22 January 2010
- 1. Garewal M, Selhorst JB. Subclavian artery dissection and triple Infarction of the Nervous System. Arch Neurol 2005;62:1917-1919.
- 2. Scheffler P, Uder M, Gross J, Pindur G. Dissection of the proximal subclavian artery with consecutive thrombosis and embolic occlusion of the hand arteries after playing golf. Am J Sports Med 2003;31: 137-140.
Correspondence:
Publication Dates
-
Publication in this collection
24 June 2010 -
Date of issue
June 2010
