Clinical Case Database / Category: Patient Management

Vertebral artery dissection

Publication details

Kelsey Boddington, MBBCh (Hons), Dejene Shiferaw, MRCP, UK
Foundation Years Journal, volume 4, issue 3, p.33 (123Doc Education, London, March 2010)


This case-based discussion focuses on a previously fit and well 38-year-old lady, 2 weeks post-partum, presenting with two seizures post-neck manipulation and discusses presentation, causes, diagnosis and management of vertebral artery dissection.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Foundation Years Clinical Cases Database£29.006 months
Add to cart
Foundation Years Clinical Cases Database£39.0012 months
Add to cart


Kelsey Boddington, MBBCh (Hons)

North Devon District Hospital

Dejene Shiferaw, MRCP, UK

CT2 North Devon District Hospital


1. Thanvi B, Munshi SK, Dawson SL, Robinson TG (2005) Carotid and vertebral artery dissection syndromes. PMJ, 81:383–388.
2. Prabhadar S, Bhatia R, Khandelwal N, Lal V, Das CP (2001) Vertebral artery dissection due to indirect neck trauma: an underrecognised entitity. Neurology India, 49(4):384–390.
3. Schievink WI (2001) Spontaneous dissection of the carotid and vertebral arteries. The New England Journal of Medicine, 344(12):898–906.
4. Rubinstein SM, Peerdeman, SM, van Tulder MW, Riphagen I, Haldeman S (2005) A systematic review of risk factors for cervical artery dissection. Stroke, 36:1575–1580.
5. Blunt SB, Galton C (1997) Cervical carotid or vertebral artery dissection: An under-diagnosed cause of stroke in the young. BMJ, 314:243.
6. Tramo MJ, Hainline B, Petito F, Lee B, Caronna J (1985) Vertebral artery injury and cerebellar stroke while swimming: case report. Stroke, 16:1039–1042.
7. Ernst, E (2007) Adverse effects of spinal manipulation: a systematic review. Journal of the royal society of medicine, 100:330–338.
8. Rothwell DM, Bondy SJ, Williams JI (2001) Chiropractic manipulation and stroke: a population-based case control study. Stroke, 32:1054–1060.
9. Di Fabio RP (1999) Manipulation of the cervical spine: Risks and benefits. Physical Therapy, 79(1):50–65.
10. Norris JW, Beletsky (2001) Update from the Canadian stroke consortium. CMAJ, 165(7):887.
11. Kapral MK, Bondy SJ (2001) Cervical manipulation and risk of stroke. CMAJ, 165(7):907–908.
12. Arnold M, Camus-Jacqmin M, Ducros CSA, Viswanathan A, Berthet K, Bousser MG (2008) Post-partum cercocephalic artery dissection. Stroke, 39:2377–2379.
13. Gasicki AP, Kwiecenski H, Lyrer PA, Lynch TG, Baxter T (1999) Dissections after childbirth. J Neurol, 246:712–715.
14. Treadwell SD, Thanvi B, Robinson TG (2008) Stroke in pregnancy and the puerperium. PMJ, 84:238–245.
15. Wiebers DO, Mokri B (1985) Internal carotid artery dissection after childbirth. Stroke, 16:956–959.
16. Silbert PL, Mokri B, Schievink WI (1995) Headache and neck pain in spontaneous internal carotid and vertebral artery dissections. Neurology, 45:1517–1522.
17. Schievink WI (2000) The treatment of spontaneous carotid and vertebral artery dissections. Current opinion in cardiology, 15:316–321.
18. Wityk RJ (2001) Stroke in a healthy 46-year-old man. JAMA, 285(21):2757–2762.
19. Touzé E, Oppenheim C, Zuber M, Méary E, Meder JF, Mas JL (2003) Early asymptomatic recurrence of cervical artery dissection: three cases. Neurology, 61:572–574.
20. Umasankar U, Carroll TJ, Famuboni A, Patel MD, Starke ID (2008) Vertebral artery dissection: not a rare cause of stroke in the young. Age and ageing, 37:345–346.


Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts ( The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.