Practice of Medicine

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Vertebral Artery Dissection: An Under-Recognized Cause of Stroke in the Young

By: Peter D. Steckl MD, FACEP, Georgette Samaritan, RN,

The Case

A 33 YOM with a one-week history of a worsening URI presented to the emergency department (ED) after sudden onset of a posterior headache immediately followed by extreme vertigo. These symptoms began 2 hours earlier following a particularly violent coughing episode in which he flexed his neck forward while lying supine in bed. He felt as though he might vomit, lurched from bed, and was …


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