Ischemic stroke as a complication of whiplash injury to the neck: a clinical observation

The article presents a clinical observation of an ischemic stroke resulted from the vertebral artery dissection, a rare complication of whiplash injury of the cervical spine. Acute condition developed with a delayed onset in the form of headache and pain in the cervical spine after a minor car accident in a young woman with signs of mesenchymal vascular dysplasia, followed by a transient episode of ataxia, dysarthria. The assessment of a patient’s neurological status on admission to the clinic showed focal neurological symptoms (right-sided hemianopsia and hemihypesthesia). Brain MRI revealed an ischemic lesion in the occipital lobe in the left hemisphere. Duplex scanning and CT angiography showed stenosis of both vertebral arteries (60–70%) due to their dissection. Vertebral and myofascial syndromes at the cervical level were detected after the patient underwent neuroorthopedic examination; the neuropsychological test battery findings demonstrated a high level of anxiety and depression. The patient received treatment with heparin followed by switching to acetylsalicylic acid, nimesulide, sertraline, phenazepam and omeprazole, as well as complex non-drug treatment: kinesiotherapy, elements of psychological correction. The treatment resulted in the regression of clinical symptoms, pain relief, and decreased level of anxiety and depressive disorders. The follow-up vessel examination demonstrated a gradual regression of lumbar artery stenosis. The article discusses the issues of pathogenesis, diagnosis, management of whiplash injury and artery dissection. It ought to be noted that symptoms of uncomplicated whiplash injury and artery dissection