• Jing Zhao, Bin Luo, Xinlu Yao, Xiaoyun Zhang, Daquan He, Lina Cai, Yahui Xu, Qin Li, and Zhirong Wan.
• Department of Neurology, Aerospace Center Hospital, Beijing 100049, China.
• Medicine (Baltimore). 2023 Jun 16; 102 (24): e34033e34033.

RationaleVertebral artery dissection is an important cause of posterior circulation ischemic stroke in young and middle-aged people. We reported a young man with cerebellar infarction caused by dissection of the right vertebral artery.Patient ConcernsA 34-year-old man presented with intermittent dizziness, blurred vision, nausea, and transient tinnitus 10 days before admission. All these symptoms were gradually aggravated and followed by vomiting and unfavorable movement of the right limbs. All these symptoms gradually aggravated.DiagnosisNeurological examination on admission showed ataxia of the right limbs. Magnetic resonance imaging of the head revealed a right cerebellar infarction. High-resolution vessel wall magnetic resonance imaging showed dissection of the right vertebral artery. Whole-brain CT digital subtraction angiography revealed occlusion of the third segment (V3) of the right vertebral artery. This supports the diagnosis of vertebral artery dissection.InterventionsThe patient received anticoagulant treatment with warfarin.OutcomesAfter 2 weeks of treatment, the patient showed remarkably alleviated dizziness and unfavorable movement of the right limbs. After 3 months of treatment, the modified Rankin Scale score was 0. MRI of the head revealed that the original right cerebellar focus was softened, and there were no newly formed infarct foci.LessonsWhen young and middle-aged patients without atherosclerotic risk factors encounter sudden dizziness, tinnitus, and unfavorable limb movement, vertebral artery dissection may be considered. Careful inquiry into the medical history may help make a final diagnosis. Further high-resolution vessel wall magnetic resonance imaging is an effective means to find arterial dissection. Early diagnosis and treatment for vertebral artery dissection has a favorable prognosis.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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