Asian Spine J.  2013 Dec;7(4):335-338. 10.4184/asj.2013.7.4.335.

Vertebral Artery Dissection as a Cause of Cervical Radiculopathy

• Silbert BI
• Khangure M
• Silbert PL

• KMID: 2270415
• DOI: http://doi.org/10.4184/asj.2013.7.4.335

Abstract

The acute onset of neck pain and arm weakness is most commonly due to cervical radiculopathy or inflammatory brachial plexopathy. Rarely, extracranial vertebral artery dissection may cause radiculopathy in the absence of brainstem ischemia. We describe a case of vertebral artery dissection presenting as cervical radiculopathy in a previously healthy 43-year-old woman who presented with proximal left arm weakness and neck pain aggravated by movement. Cervical magnetic resonance imaging (MRI) and angiography revealed dissection of the left vertebral artery with an intramural hematoma compressing the left C5 and C6 nerve roots. Antiplatelet treatment was commenced, and full power returned after 2 months. Recognition of vertebral artery dissection on cervical MRI as a possible cause of cervical radiculopathy is important to avoid interventions within the intervertebral foramen such as surgery or nerve root sleeve injection. Treatment with antithrombotic agents is important to prevent secondary ischemic events.

Keyword

Vertebral artery dissection; Neck pain; Radiculopathy; Cervical spine

MeSH Terms

Adult
Angiography
Arm
Brachial Plexus Neuropathies
Brain Stem
Female
Fibrinolytic Agents
Hematoma
Humans
Ischemia
Magnetic Resonance Imaging
Neck Pain
Radiculopathy*
Vertebral Artery Dissection*
Vertebral Artery*
Fibrinolytic Agents