| Autor: |
Camilo GB; Departamento de Radiologia do Hospital e Maternidade Terezinha de Jesus - HMTJ e da Faculdade de Ciências Médicas e da Saúde de Juiz de Fora - SUPREMA, Juiz de Fora, MG, Brasil.; Programa de Pós Graduação em Saúde Brasileira da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil., Riccio MA; Programa de Pós Graduação em Saúde Brasileira da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil.; Departamento de Neurocirurgia da Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil., Nogueira ALM; Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (FCMS JF/SUPREMA), Juiz de Fora, MG, Brasil., Querubino AC; Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (FCMS JF/SUPREMA), Juiz de Fora, MG, Brasil., Maciel ALDS; Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (FCMS JF/SUPREMA), Juiz de Fora, MG, Brasil., Rodrigues DGPL; Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (FCMS JF/SUPREMA), Juiz de Fora, MG, Brasil., Sá Júnior CAC; Médico Emergencista e Diretor clínico da Rodovia 393, Juiz de Fora, MG, Brasil. |
| Abstrakt: |
Vertebral Artery Dissection (VAD) is a rare condition that can be caused by a wide amplitude of neck movement, which injures the vessel wall and can cause ischemia in the cerebellum. We present a 37-year-old man with herniated lumbar disc and allergic rhinosinusitis, which caused sneezing spells. After one of these bouts with a ricochet of the head, he presented C3 misalignment with local pain. Twenty-one days later, affected by a new crisis, he presented left temporal headache, nystagmus, and vertigo. After 3 days, Magnetic Resonance Imaging (MRI) identified 2 regions of cerebellar ischemia and filling failure of the right vertebral artery. After 2 days, Computed Angiotomography (CT Angiography) was performed and showed right VAD with a local thrombus, without aneurysmal signs. Transcranial Doppler did not indicate an increase in blood flow from this artery. The suggested treatment involved administration of anticoagulant Apixabana 5mg, 12/12h, for 3 months, until the condition was reevaluated with new Angio CT and MRI. It was recommended that the patient was released from work for 1 month and forbidden from doing intense physical exercises for 3 months; however, due to setbacks, these deadlines were extended until a new appointment, 4 months after the first visit. The new tests showed no changes, indicating that the condition was stable. This case aims to indicate the possible investigations of the diagnosis and therapeutic options of the rare association between VAD with cerebellar infarction in a well-documented case. |
