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Hyperdense posterior cerebral artery sign in a setting of spontaneous vertebral artery dissection: a blessing in disguise?

Publication ,  Journal Article
Gokhale, S; Graffagnino, C
Published in: Med Princ Pract
2014

OBJECTIVE: To report a case of a hyperdense posterior cerebral artery (PCA) sign in the setting of spontaneous vertebral artery dissection. CLINICAL PRESENTATION AND INTERVENTION: A 28-year-old, previously healthy female presented with rapidly progressive coma. A noncontrast computerized tomographic (CT) scan showed a hyperdense PCA sign, which prompted an urgent arteriogram. She was found to have spontaneous vertebral artery dissection with an occluding thrombus. She underwent intra-arterial thrombolysis with tissue plasminogen activator. Follow-up magnetic resonance imaging showed an area of acute infarction in the medial temporal and occipital regions corresponding to the area supplied by the left PCA. The patient was started on systemic anticoagulation therapy with intravenous heparin. She showed slow and continued recovery but was left with significant neurological deficits that required posthospital discharge to a long-term rehabilitation facility. CONCLUSION: This case showed that the hyperdense PCA sign on a noncontrast CT scan necessitated an emergent CT angiogram that showed vertebral artery dissection and a devastating vascular occlusion. Hence, we suggest an early intervention that may allow for potential revascularization therapy.

Duke Scholars

Published In

Med Princ Pract

DOI

EISSN

1423-0151

Publication Date

2014

Volume

23

Issue

1

Start / End Page

86 / 88

Location

Switzerland

Related Subject Headings

  • Vertebral Artery Dissection
  • Tomography, X-Ray Computed
  • Tissue Plasminogen Activator
  • Posterior Cerebral Artery
  • Microbiology
  • Magnetic Resonance Imaging
  • Humans
  • Fibrinolytic Agents
  • Female
  • Adult
 

Citation

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ICMJE
MLA
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Gokhale, S., & Graffagnino, C. (2014). Hyperdense posterior cerebral artery sign in a setting of spontaneous vertebral artery dissection: a blessing in disguise? Med Princ Pract, 23(1), 86–88. https://doi.org/10.1159/000351694
Gokhale, Sankalp, and Carmelo Graffagnino. “Hyperdense posterior cerebral artery sign in a setting of spontaneous vertebral artery dissection: a blessing in disguise?Med Princ Pract 23, no. 1 (2014): 86–88. https://doi.org/10.1159/000351694.
Gokhale, Sankalp, and Carmelo Graffagnino. “Hyperdense posterior cerebral artery sign in a setting of spontaneous vertebral artery dissection: a blessing in disguise?Med Princ Pract, vol. 23, no. 1, 2014, pp. 86–88. Pubmed, doi:10.1159/000351694.
Journal cover image

Published In

Med Princ Pract

DOI

EISSN

1423-0151

Publication Date

2014

Volume

23

Issue

1

Start / End Page

86 / 88

Location

Switzerland

Related Subject Headings

  • Vertebral Artery Dissection
  • Tomography, X-Ray Computed
  • Tissue Plasminogen Activator
  • Posterior Cerebral Artery
  • Microbiology
  • Magnetic Resonance Imaging
  • Humans
  • Fibrinolytic Agents
  • Female
  • Adult