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(Stroke. 1996;27:2325-2327.)
© 1996 American Heart Association, Inc.

Articles

Bilateral Vertebral Artery Dissection in a Patient With Afibrinogenemia

Juan C. Garcia-Monco, MD; Guillermo Fernandez Canton, MD Marian Gomez Beldarrain, MD

the Neurology Department and Magnetic Resonance Unit "Osatek" (G.F.C.), Hospital de Galdacano, Vizcaya, Spain.

Background Afibrinogenemia, a rare coagulation disorder, has not been associated with vertebral artery dissections.

Case Description A 28-year-old woman with afibrinogenemia developed spontaneous neck pain followed by a right medullary infarction, and MR angiography showed extensive bilateral vertebral artery dissection. She was treated with fibrinogen replacement and anticoagulants and showed a favorable evolution, with only mild residual right upper arm incoordination.

Conclusions In this patient spontaneous bilateral vertebral artery dissection complicated afibrinogenemia. Since anticoagulant therapy is usually indicated for arterial dissection, this association created a therapeutic problem. This patient received anticoagulants with fibrinogen replacement, which resulted in a favorable evolution.

Key Words: coagulation • dissection • magnetic resonance imaging • vertebral artery

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