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Spinal sulcal artery syndrome due to spontaneous bilateral vertebral artery dissection
  1. S WEIDAUER,
  2. D CLAUS
  1. Department of Neurology
  2. Institute for Radiology, Klinikum Darmstadt, Teaching Hospital University Frankfurt, Germany
  1. Professor D Claus, Department of Neurology, Klinikum Darmstadt, Teaching Hospital University Frankfurt, Heidelberger Landstrasse 379, 64297 Darmstadt, Germany.
  1. M GARTENSCHLÄGER
  1. Department of Neurology
  2. Institute for Radiology, Klinikum Darmstadt, Teaching Hospital University Frankfurt, Germany
  1. Professor D Claus, Department of Neurology, Klinikum Darmstadt, Teaching Hospital University Frankfurt, Heidelberger Landstrasse 379, 64297 Darmstadt, Germany.

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In young adults vertebral artery dissection (VAD) is an important cause of brain infarction.1 2 A known mechanism is microtraumata due to abrupt head movements— for example, chiropractic manoeuvres. In addition a pathogenetic role of connective tissue diseases, cystic media necrosis, fibromuscular dysplasia, migraine, and inflammatory diseases has been postulated.3In VAD initial neck pain is often reported, which may be slight. Lesions caused by VAD are cerebellar or brainstem infarcts, unilateral or bilateral thalamic infarcts (top of the basilar syndrome), or infarctions in the posterior cerebral artery territory due to intra-arterial embolism or haemodynamic decompensation when collaterals are insufficient.1 Lesions of the cervical spinal cord are rare because of its good collateral supply.4 5 We report on a patient with a syndrome of the spinal sulcal artery (incomplete Brown-Séquard syndrome) caused by spontaneous bilateral VAD.

A 43 year old man with a history of arterial hypertension presented with left sided numbness sparing the face, which had evolved suddenly while he was walking. In addition, he reported on dull right sided neck pain irradiating into the occiput, …

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