Cervical Posterior Spinal Artery Syndrome Caused By Spontaneous Vertebral Artery Dissection: Two Case Reports and Literature Review

J Stroke Cerebrovasc Dis. 2020 Mar;29(3):104601. doi: 10.1016/j.jstrokecerebrovasdis.2019.104601. Epub 2020 Jan 6.

Abstract

Herein, we described 2 patients with posterior spinal artery syndrome (PSAS) caused by vertebral artery dissection. The patients complained of sudden neck pain or walking instability. Neurological examination revealed sensory loss, muscle weakness, and sensory ataxia. Angiography showed double lumen sign or intimal flap in the vertebral artery. T2-weighted imaging and diffusion-weighted imaging of MRI showed a hyperintense lesion in the dorsal side of the cervical spinal cord at different times after onset. Both patients had good outcome after antiplatelet therapy and physiotherapy. A review of previously reported PSAS cases was also conducted in order to improve the understanding and awareness of this rare myelopathy.

Keywords: Vertebral artery dissection; magnetic resonance image; posterior spinal artery syndrome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Female
  • Gait
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology
  • Gait Disorders, Neurologic / therapy
  • Humans
  • Male
  • Neck Pain / etiology
  • Neck Pain / physiopathology
  • Neck Pain / therapy
  • Physical Therapy Modalities
  • Platelet Aggregation Inhibitors / therapeutic use
  • Recovery of Function
  • Spinal Cord Vascular Diseases / diagnostic imaging
  • Spinal Cord Vascular Diseases / etiology*
  • Spinal Cord Vascular Diseases / physiopathology
  • Spinal Cord Vascular Diseases / therapy
  • Treatment Outcome
  • Vertebral Artery Dissection / complications*
  • Vertebral Artery Dissection / diagnostic imaging
  • Vertebral Artery Dissection / physiopathology
  • Vertebral Artery Dissection / therapy

Substances

  • Platelet Aggregation Inhibitors