Clinical Practice and Cases in Emergency Medicine (Oct 2023)

Cerebellar Infarction from a Vertebral Artery Dissection after Blunt Chest Injury: A Case Report

  • Daniella Lamour,
  • Joshua J. Solano,
  • Jovana Rutherford,
  • Scott M. Alter

DOI
https://doi.org/10.5811/cpcem.1301
Journal volume & issue
Vol. 7, no. 4
pp. 230 – 233

Abstract

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Introduction: Traumatic vertebral artery dissections resulting in stroke are relatively rare occurrences, especially in the absence of classic physical examination findings. Case Report: We present the case of a 30-year-old male with chest pain following a car axle falling onto his chest while trying to change a tire. He was discharged from the emergency department after having a negative workup for thoracic injury. Six hours later, the patient returned with headache and was found to have a cerebellar stroke secondary to vertebral artery dissection. After hospitalization, the patient was discharged home without any neurological deficits. Conclusion: As they are usually asymptomatic, up to 80% of patients with blunt cerebrovascular injury will have delayed or missed diagnoses. Given the increased awareness of vascular injuries and their high morbidity, physicians should maintain a high index of suspicion for this diagnosis.