[Postoperative dissection of the vertebral artery in two steps.]

We report a case revealed by a tegmento-thalamic stroke after an abdominal second surgical look. The interest of this observation is related to a particular evolution in two steps separated by a 2-month-interval and an intercurrent cervical manipulation. After the second anesthesia, neck pain associated with a third cranial nerve palsy and a supranuclear ophtalmoplegia revealed a tegmento-thalamic ischemic stroke due to vertebral artery dissection. We discuss here the different factors possibly involved in the pathophysiology of postoperative vertebral artery dissection: positioning, cervical manipulation, subclavian central venous access and cisplatin toxicity. Vertebral artery dissection should be discussed in case of postoperative neck pain, especially with non-typical symptomatology. PMID: 25447780 [PubMed - as supplied by publisher]
Source: Annales Francaises d'Anesthesie et de Reanimation - Category: Anesthesiology Authors: Tags: Ann Fr Anesth Reanim Source Type: research