Work

The use of dynamic magnetic resonance angiography in the diagnosis of rotational vertebral artery syndrome

Year: 2024

Type: article

Abstract: Background: Rotational vertebral artery (VA) syndrome represents a rare mechanical vasculopathy that can lead to vertebrobasilar insufficiency and ischemic stroke. Objective: We describe a 10-year-old boy with a history of chronic morning emesis who presented with acute onset dizziness, gait instability, and vomiting and was diagnosed with acute ischemic posterior circulation stroke. Interpretation: Contrast-enhanced magnetic resonance angiography (MRA) of the head and neck with dynamic positioning demonstrated loss of flow-related enhancement with head tilted to the left, conferring a diagnosis of rotational VA syndrome. He started aspirin monotherapy and subsequently underwent C1 laminectomy, with both radiographic and clinical improvement on follow-up. Conclusion: Dynamic contrasted-enhanced MRA imaging can serve as a noninvasive alternative to digital subtraction angiography in the diagnosis of rotational VA syndrome and should be considered in suspected cases of pediatric rotational arteriopathy.

Source: Annals of the Child Neurology Society

DOI: 10.1002/cns3.20091

Authors: Chrisoula Cheronis, Grant L. Lin, Andrew Silverman, Alexandra Johnson, Sarah Lee

Institution: Stanford Medicine

Language: English

Topic: Cerebrovascular and Carotid Artery Diseases

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,000