Cerebral infarction occurs predominantly in the elderly, but may occur in young adults, especially when complicated with collagen disease, heart disease, and dissecting aneurysm. Four patients (range: 31-47 years old) complaining of a sudden onset of vertigo and nausea without a history of trauma are presented. Emergency computed tomography was initially interpreted as normal, but subsequent magnetic resonance imaging and a magnetic resonance angiogram disclosed vertebral artery (VA) dissection. Arterial dissection resulting in embolic stroke in the area of the ipsilateral posterior inferior cerebellar artery was suspected. All patients were treated conservatively without sequelae. Spontaneous VA dissection should be suspected in young patients presenting with ischemic stroke but without predisposing risk factors or associated trauma.
