Unilateral non traumatic vertebral artery dissection with cervical spinal cord infarction.

A 45-year old male patient with diabetes presented neck pain with paresthesia and paresis in upper limbs. Physical examination: proximal paraparesis, hyporeflexia and hypoesthesia in the upper limbs. MRI: ischemia in the right hemi-spinal cord (Fig 1), associated to right vertebral artery (VA) dissection (Fig 2). Although more frequently VA dissection causes transient ischemic attack or stroke1, there are few reported cases of ischemia of the cervical cord. VA branches may feed the cervical part of the anterior spinal artery on one or both sides and its occlusion by VA dissection may cause hypoperfusion in this territory2.