Spontaneous vertebral artery dissection (VAD) is common after minor neck trauma or abrupt neck manipulation, which may result in stroke. However, violent cough is a less recognised cause of VAD. Only a few cases are reported in the literature. We review the literature and report a case of a 62-year-old man who presented with a headache and neck pain following a period of intermittent coughing, which led to VAD and a cerebellar ischaemic stroke. He responded well to medical treatment and made a full recovery. Therefore, VAD should be considered in the differential diagnosis for patients presenting with neck pain and headache after episodes of violent coughing.
Yesilot BarlasNPutaalaJWaje-AndreassenU, et alEtiology of first-ever ischaemic stroke in European young adults: the 15 cities young stroke study. Eur J Neurol2013; 20: 1431–9.
2.
PrasadNMitraAShlobinNA, et alTraumatic and spontaneous vertebral artery dissections: an analysis of tertiary-center 310 patient cohort. Oper Neurosurg (Hagerstown)2021; 21: 343–50.
3.
ParkK-WParkJ-SHwangS-C, et alVertebral artery dissection: natural history, clinical features and therapeutic considerations. J Korean Neurosurg Soc2008; 44: 109.
FingerGdo NascimentoTLTessaroJC, et alTraumatic dissection of arterial cervical vessels: report of two cases and literature review. Arq Bras Neurocir2021; 40: e245–e52.
6.
ElkadyAGhazalSAlanziA, et alSpontaneous vertebral artery dissection is an under-recognized cause of stroke in young patients: two case reports and review. Cureus2020; 12: e9183.
7.
HerrRDCallGBanksD.Vertebral artery dissection from neck flexion during paroxysmal coughing. Ann Emerg Med1992; 21: 88–91.
8.
NomuraMKannukiSKuwayamaK, et alA patient with Wallenberg’s syndrome induced by severe cough. J Clin Neurosci2004; 11: 179–82.
9.
LouEZüchnerSVanceJ, et alA potential novel variant of hereditary sensory neuropathy in a 61-year-old man with cough-induced syncope and vertebral artery dissection. Mayo Clin Proc2010; 85: 594–5.
10.
ChouFHTungCSLinPJ, et alSpontaneous dissection of the vertebral artery: report of three cases. Acta Neurol Taiwan2011; 20: 149–54.
11.
GrahamMCunicoJKoehnT.Cough-induced bilateral vertebral artery dissections in an active duty service member with complete angiographic resolution (P8-5.005). Neurology2024; 102(Suppl 1): 206565.
12.
SilbertPLMokriBSchievinkWI.Headache and neck pain in spontaneous internal carotid and vertebral artery dissections. Neurology1995; 45: 1517–22.
13.
SchievinkWIMokriBO’FallonWM.Recurrent spontaneous cervical-artery dissection. N Engl J Med1994; 330: 393–7.
14.
HicksPALeavittJAMokriB.Ophthalmic manifestations of vertebral artery dissection. Ophthalmology1994; 101: 1786–92.
15.
ArnoldMBousserMGFahrniG, et alVertebral artery dissection: presenting findings and predictors of outcome. Stroke2006; 37: 2499–503.
16.
RodallecMHMarteauVGerberS, et alCraniocervical arterial dissection: spectrum of imaging findings and differential diagnosis. Radiographics2008; 28: 1711–28.
17.
GrauAJBrandtTBuggleF, et alAssociation of cervical artery dissection with recent infection. Arch Neurol1999; 56: 851–6.
18.
YaghiSEngelterSDel BrunttoVJ, et alTreatment and outcomes of cervical artery dissection in adults: a scientific statement from the American Heart Association. Stroke2024; 55:e91–e106.
19.
YeSLWangCWangLL, et alOral anticoagulant and antiplatelet therapy for cervical artery dissection: a meta-analysis of clinical trials. Clin Appl Thromb Hemost2021; 27: 10760296211051708.
20.
TheEZLinNNChanCJ, et alAntiplatelets or anticoagulants? Secondary prevention in cervical artery dissection: an updated meta-analysis. Neurol Res Pract2022; 4: 23.
21.
EssibayiMALanzinoGKeserZ.Vitamin K antagonist versus novel oral anticoagulants for management of cervical artery dissection: interactive systematic review and meta-analysis. Eur Stroke J2022; 7: 349–57.
22.
UrasyanandanaKSongsangDAurboonyawatT, et alTreatment outcomes in cerebral artery dissection and literature review. Interv Neuroradiol2018; 24: 254–62.
