We report a case of left upper cervical posterior spinal artery (PSA) syndrome caused
by atherosclerosis of the left vertebral artery. A 70-year-old female experienced
sudden dizziness and paralysis of the left upper and lower limbs. Diffusion-weighted
magnetic resonance imaging (DWI) of the brain showed high signal intensity at the
vermis and lower left hemisphere of the cerebellum, and magnetic resonance angiography
showed that the entire left vertebral artery was thin. The patient was treated with
an intravenous infusion of tissue plasminogen activator 2 hours after symptom onset
and made a full recovery. Repeat DWI, fluid-attenuated inversion recovery images,
and T2-weighted images showed high signal intensity in the left upper cervical PSA
area from the lower medulla oblongata to the C2 level in addition to the cerebellum.
Previously reported cases of cervical posterior artery syndrome are reviewed.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Spinal cord infarction. Report of 8 cases and review of the literature.Medicine (Baltimore). 1989; 68: 282-292
- Infarction of the medulla and cervical cord after fitness exercises.Stroke. 1989; 20: 292-294
- Unilateral upper cervical posterior spinal artery syndrome following sneezing.J Neurol Neurosurg Psychiatry. 1992; 55: 841-843
- Unilateral posterior spinal artery syndrome of the upper cervical cord associated with vertebral artery occlusion.Rinsho Shinkeigaku. 1994; 34: 1171-1174
- Posterior cervical spinal cord infarction following vertebral artery dissection.Neurology. 1997; 48: 1112-1115
- Infarct presenting with a combination of Wallenberg and posterior spinal artery syndromes.J Neurol Sci. 2000; 176: 155-157
- Unilateral infarct in the posterior spinal artery territory presenting as a ‘clumsy hand’.J Neurol. 2002; 249: 1327-1328
- Combined cerebellar and bilateral cervical posterior spinal artery stroke demonstrated on MRI.Cerebrovasc Dis. 2003; 15: 143-147
- Bilateral posterior medullary and cervical stroke: a case report.Neurol Sci. 2006; 27: 281-283
- Unilateral upper cervical cord infarct restricted to the right funiculus cuneatus.Intern Med. 2008; 47: 479
- Posterior cervical spinal cord infarction following thyrocervical trunk embolization.Eur Neurol. 2008; 59: 200-201
- Unilateral right occipital condyle to C2 level spinal cord infarction associated with ipsilateral vertebral artery stenosis and contralateral vertebral artery dissection: a case report.J Spinal Cord Med. 2011; 34: 118-121
- Unusual sensory disturbances revealing posterior spinal artery infarct.Case Rep Neurol. 2012; 4: 23-27
- A case of posterior spinal artery syndrome in the cervical cord: a review of the clinicoradiological literature.Intern Med. 2012; 51: 803-807
- Posterior spinal artery syndrome showing marked swelling of the spinal cord: a clinico-pathological study.J Spinal Cord Med. 2013; 36: 31-35
- Unilateral posterior cervical spinal cord infarction due to spontaneous vertebral artery dissection.J Spinal Cord Med. 2014; 37: 233-236
- Spinal cord ischemia.in: Barnett H.J.M. Mohr J.P. Stein B.A. Stroke. Churchill Livingstone, New York1998: 751-765
- Pathology, classification and clinical aspects of vascular diseases of the spinal cord.in: Handbook of clinical neurology. vol. 12. North-Holland, Oxford1972: 492-506
Article info
Publication history
Published online: March 21, 2016
Accepted:
February 11,
2016
Received in revised form:
January 12,
2016
Received:
November 26,
2015
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.018
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
