Vertebral artery dissection presented as lateral medullary syndrome in a patient with migraine

A case report

Ju Chun Yen, Lung Chan, Yen J. Lai

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Migraine and artery dissection are both rare causes of ischemic stroke1. The mechanism of migraine-related intracranial artery dissection is still unknown. It is proposed that the repeated attack of migraine would make the involved artery more vulnerable to tearing and lead to dissection3. Case report: We describe a 42-year-old female suffering from basilar-type migraine for more than 20 years. The patient complained severe dizziness with hyperventilation while watching television. Initially anxiety and migraine attack were impressed in the emergency room, but dizziness accompanied with dysarthria and dysphagia was noted later. After admission, lateral medullary syndrome was suspected after a detailed neurological examination, and a brain magnetic resonance image (MRI) revealed an acute infarction on the left lateral medulla oblongata, confirming the clinical diagnosis Furthermore, cerebral angiography revealed the left distal vertebral artery dissection. The patient was reluctant to use an anticoagulant; therefore aspirin was given for secondary stroke prevention and topiramate for migraine prophylaxis. Conclusion: The exact mechanism of migraine-related intracranial artery dissection has yet to be proven, we propose that this may be caused by vessel wall edematous changes with repeated migraine attacks resulting in sudden or unusual stretching.

Original languageEnglish
Pages (from-to)275-280
Number of pages6
JournalActa Neurologica Taiwanica
Volume19
Issue number4
Publication statusPublished - Dec 1 2010
Externally publishedYes

Fingerprint

Lateral Medullary Syndrome
Vertebral Artery Dissection
Migraine Disorders
Arteries
Dissection
Dizziness
Migraine with Aura
Dysarthria
Medulla Oblongata
Cerebral Angiography
Hyperventilation
Television
Neurologic Examination
Deglutition Disorders
Secondary Prevention
Anticoagulants
Infarction
Aspirin
Hospital Emergency Service
Magnetic Resonance Spectroscopy

Keywords

  • Lateral medullary syndrome
  • Migraine
  • Topiramate
  • Vertebral artery dissection

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Vertebral artery dissection presented as lateral medullary syndrome in a patient with migraine : A case report. / Yen, Ju Chun; Chan, Lung; Lai, Yen J.

In: Acta Neurologica Taiwanica, Vol. 19, No. 4, 01.12.2010, p. 275-280.

Research output: Contribution to journalArticle

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