DISSECTION OF THE VERTEBRAL ARTERY WITH CERVICAL NERVE ROOT LESIONS

Vertebral artery dissection may cause upper limb peripheral motor defi cit. We report three young patients presenting with nuchal pain follow ed by a nearly painless proximal paresis of the arm several days later . The cause, as detected by colour-coded Duplex sonography and MRI, wa s an extracranial dissection of the vertebral artery. The proximity of the intervertebral segment to the vertebral artery and the nerve root s indicated that compression by an intramural haematoma was the likely cause of the disorder. Subsequent examinations during anticoagulation treatment showed almost complete disappearance of the intramural haem atoma and of the neurological deficits within a few weeks. We believe that the occurrence of an upper limb peripheral motor deficit should b e added to the spectrum of potentially misleading signs of vertebral a rtery dissection.