Extracranial vertebral artery dissection causing cervical root lesion

The authors report an unusual manifestation of extracranial vertebral arter y dissection (VAD), presenting with a predominantly motor radicular manifes tation. Cervical magnetic resonance imaging (MRI) revealed the in intramura l hematoma in the dissected vessel wall, compressing mainly the segmental m otor root and, to a lesser degree, the sensory ganglion. In the digital sub traction angiography (DSA), a circumscribed narrowing of the incriminated v essel was demonstrated. Color-coded Duplex imaging (CDDI) revealed complete recanalization after a few days of anticoagulation treatment. Complete neu rologic recovery was seen after 3 months. Considering the MRI data, the lik ely pathogenetic mechanism was compression of the nerve root by the intramu ral hematoma. The synopsis with similar cases in the literature points to t he characteristic features, i.e., the association of neck pain with radicul ar motor deficit and the absence of degenerative disk disease. The respecti ve syndrome should raise the suspicion of vertebral artery dissection, espe cially in young individuals.