Abstract
Vertebral arterial dissection (VAD) is a rarely observed cause of vertebrobasilar
ischemia. It is often reported as individual case reports in children, and the underlying
cause is usually congenital anomalies or trauma to the neck. In this case report,
we present a pediatric case of VAD whose magnetic resonance (MR) and computed tomography
angiographies were normal and could only be diagnosed after a careful reassessment
of the initial brain MRIs considering the dynamic nature of the dissection process.
Etiological investigations pointed to the patient's neck tics as the origin of the
condition, which is a rare and interesting cause different from the previously reported
cases in the literature. Due to the ischemic lesions in the brain stem and the cerebellum,
low molecular weight heparin treatment was started and the neurological symptoms rapidly
receded. Since a severe tic disorder involving the face and neck has been observed
as a rare cause of VAD aside from the previously reported causes such as the Bow–Hunter
syndrome reported in archers, congenital cervical anomalies, traumatic mechanical
accidents, and cervical chiropractical maneuvers, the sharing of this case will contribute
to the literature.
Keywords
pediatric stroke - vertebral artery - dissection - occlusion
