A case of vertebral artery dissection complicated with repeated cerebral embolism

Abstract

Cerebral artery dissection can be a cause of cerebral infarction, especially in the young people. It is difficult to diagnose the arterial dissection since the deformity is very little in the early stage. A 40-year-old man presented with visual field disturbance. MR diffusion-weighted image showed multiple high-intensity lesions in the posterior circulation. Vascular abnormality was not detected by MR angiography. In spite of administration of antithrombotic therapy, cerebral infarction repeated in the posterior circulation. An antiphospholipid antibody was positive. Neither ultrasound study nor radiological study could show the cause of cerebral infarction. Finally, conventional vertebral angiogram revealed dilatation at the V2-3 portion of the right vertebral artery, and we made a diagnosis of the right vertebral artery dissection. In case of repeated cerebral infarction in the same vascular territory, radiological study including conventional cerebral angiography is needed.