Vertebral artery dissection as the cause of recurrent transient ischemic attack

Vertebral artery dissection (VAD) has only recently been recognized as a rare cause of transient ischemic attack (TIA) or infarction in vertebrobasilar basin. Development of new diagnostic techniques associated with lower risk for the patient has resulted in a higher rate of this diagnosis. Early diagnosis is even more important knowing that cerebral infarction may ensue weeks after dissection. The symptoms of cerebellar or brain stem infarction can be prevented or alleviated by early diagnosis and timely treatment. Development of thrombi and potential thromboembolic events in vertebrobasilar basin can usually be prevented by timely anticoagulant therapy. Experiences acquired to date suggest that cerebral infarction or TIA due to VAD is generally found in younger persons, however, it does not mean that VAD cannot occur in individuals older than 50. Presentation is made of a female patient with VAD and recurrent TIAs in vertebrobasilar circulation. The aim is to remind the readers that VAD is by no means so very rare or harmless cause of TIA, and to present appropriate diagnostic work-up and treatment in case of suspect VAD.