versión impresa ISSN 0004-282X
Arq. Neuro-Psiquiatr. vol.68 no.3 São Paulo jun. 2010
IMAGES IN NEUROLOGY
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
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.
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Marcos Christiano Lange
Rua General Carneiro 181 / 4º andar
80060-900 Curitiba PR - Brasil
Received 13 January 2010
Accepted 22 January 2010