Vertebral artery dissection presenting as vertigo–a rare case presentation in a young adult

Abstract Background Vertebral artery dissection (VAD) is a rare condition, especially in young adults, with an annual incidence of about 1–1.5 per 100,000 people. This case report aims to present an unusual case of vertigo in an early 30s male, initially assumed to be due to travel sickness but was later proven to be vertebral artery dissection. Case presentation: The patient reported dizziness, nausea, facial numbness, and a sore throat following travel and a massage. His medical history included no significant trauma, though he was an active boxer. Physical examination revealed vertical and horizontal nystagmus, but motor strength remained normal. A non-contrast CT scan revealed basilar artery dolichoectasia, and subsequent MRI confirmed a left VAD. The dissection was located in the fourth vertebral artery segment, a typical location for such cases. The patient was managed conservatively with anticoagulants and discharged with no new symptoms. VAD is an uncommon cause of vertigo, and its presentation in young adults without severe trauma is rare. However, subtle traumas, such as those experienced in contact sports or even minor cervical manipulation, may predispose individuals to this condition. Conclusions This case underscores the importance of thorough diagnostic evaluation for patients presenting with vertigo, as VAD can lead to life-threatening complications such as stroke. Early recognition and appropriate management are essential for a favorable prognosis​.