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KMID : 0911820220230020041
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Korean Journal of Headache
2022 Volume.23 No. 2 p.41 ~ p.44
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Persistent Headache after Pulling Physical Activity as a First Manifestation of Vertebral Artery Dissection
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Kim Byung-Su
Yu Hyun-Jeung
Jeong Eun-Hye
Sunwoo Mun-Kyung
Sung Min-Jae
Kim Dae-Yoon
Kim Hyun-Jin
Kim Jeong-Yeon
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Abstract
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Vertebral artery dissection (VAD) is a major etiology of stroke in younger population. VAD can occasionally occur after physical activity even without direct neck or head trauma. We report a patient with isolated persistent headache after excessive pulling physical activity as a sole first manifestation of VAD. A 51-year man visited our emergency department due to acute onset neurologic deficit before 5 hours. His neurologic deficits were dysarthria, dysphagia, hoarseness, numbness in right face and left arm, trunk, and leg. He experienced new daily persistent headache 18 days ago, after excessive pulling physical activity. His headache was mild-to-moderate headache intensity, non-pulsatile, fixed in the right posterior head and neck and not accompanied with nausea or vomiting. Neuroimaging revealed right VAD and associated right lateral medullary infarction. Newonset persistent headache after physical activity may be a clue for early diagnosis of VAD.
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KEYWORD
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Brain vascular malformation, Secondary headache disorders, Migraine
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