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Arquivos de Neuro-Psiquiatria

versión impresa ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.68 no.3 São Paulo jun. 2010 



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




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.



1. Garewal M, Selhorst JB. Subclavian artery dissection and triple Infarction of the Nervous System. Arch Neurol 2005;62:1917-1919.         [ Links ]

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.         [ Links ]



Marcos Christiano Lange
Rua General Carneiro 181 / 4º andar
80060-900 Curitiba PR - Brasil

Received 13 January 2010
Accepted 22 January 2010

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