Table 1

Clinical and parenchymal MRI findings in 19 patients with extracranial VADs

Patient No/sex/age	Predisposing factors	Initial symptoms	Neurological signs	Infarct territory	Treatment	Outcome
1/M/32	Fall	Neck pain (ipsilateral), headache	Hemiparesis, dysarthria, hemianopia	PCA, thalamus	Heparin, aspirin	Clinical recovery
2/M/41	—	Neck pain (ipsilateral)	Wallenberg syndrome	PICA, bilateral	Heparin, dipyramidol	Dysarthria, dysphagia
3/M/37	Smoking	Vertebrobasilar TIAs	Wallenberg syndrome	PICA	Heparin, coumarin	Clinical recovery
4/F/44	Fall	—	Cerebellar ataxia, dysarthria	PICA, bilateral, AICA	Heparin, aspirin	Ataxia
5/M/40	Skiing	Neck pain (bilateral)	Wallenberg syndrome, hemiparesis	PICA	Heparin, coumarin	Hemiparesis
6/F/30	Skiing, migraine, oral contraceptive	Neck pain (ipsilateral)	Locked in syndrome	Pontin	Heparin, coumarin	Tetraparesis, dysarthria
7/M/59	Hypertension	—	Hemiataxia, dysarthria, diplopia, nystagmus	Pontin (small)	Aspirin	Clinical recovery
8/M/51	Hypertension	Neck pain (ipsilateral), headache, vertebrobasilar TIAs	Paraparesis, nystagmus, diplopia	Pontin (small)	Heparin, coumarin	Clinical recovery
9/M/41	Fall	Headache, vertebrobasilar TIAs	Hemiataxia, hemianopia	PCA, AICA	Heparin, aspirin	Clinical recovery
10/M/40	Fall, smoking	Headache	Hemiataxia, dysarthria	PICA, AICA	Heparin, aspirin	Clinical recovery
11/F/36	Fall, smoking	Headache	Hemiparesis	None	Ligature, aspirin	Clinical recovery
12/M/32	Smoking	Neck pain (ipsilateral), headache	Wallenberg syndrome, diplopia	PICA	Heparin, aspirin	Hemihypaesthesia
13/F/32	Fall, smoking, oral contraceptive	—	Wallenberg syndrome, diplopia	PICA	Heparin, aspirin	Clinical recovery
14/F/60	Hypertension	Vertebrobasilar TIAs	Wallenberg syndrome	PICA	Coumarin, aspirin	Hemiataxia
15/M/23	Surfing	—	Somnolence, tetraparesis	Pontine (small)	Heparin, aspirin	Clinical recovery
16/F/35	Horse riding	—	Somnolence, hemiataxia, hemiparesis	PCA, thalamus	Aspirin, VA ligation	Ataxia, hemihypaesthesia
17/M/36	Hypertension, smoking	—	Wallenberg syndrome	PICA	Heparin, aspirin	Hemiataxia
18/M/47	Abrupt head turning, smoking	—	Wallenberg syndrome, hemiparesis	PICA	Heparin, pentaxifyllin	Dysarthria, hemihypaesthesia
19/F/36	Fall	Headache, vertebrobasilar TIAs	Hemiparesis	PCA, thalamus	Heparin, coumarin	Hemihypaesthesia

MRI = magnetic resonance imaging; VAD = vertebral artery dissection; TIA = transient ischaemic attack; M = male; F = female; VA = vertebral artery; PICA = posterior inferior cerebellar artery; AICA = anterior inferior cerebellar artery; PCA = posterior cerebral artery.