Stroke cerebellare e dissezione dell’arteria vertebrale in una adolescente [Cerebellar stroke and vertebral artery dissection in an adolescent]

A 13-year-old girl presented with progressive frontal he-adache, dizziness, vomiting and hypotonia, with heat sen-sation and hyperidrosis. She referred a “contraction” of the neck some days before, while she was doing gymna-stics. The only physical sign was coarse tremor of the left lower limb to the test Mingazzini. Laboratory and radio-logic exams were normal, but cerebral MRI and angio-MRI put in evidence some ischemic spots in the left cere-bellar emisphere and cerebellar vermis; they originated from a dissection of the vertebral artery, evidenced by an angio-MRI of the supra-aortic arteries. After 10 months of low dose acetylsalicylic acid therapy, symptoms resol-ved almost completely, with no new ischemic events. The cerebellar lesions were resolving, as well as the small pseudoaneurysm at the level of dissection. Cerebellar stroke is rare in children, the spontaneous dissection of the vertebral arteries can be one of the possible etiolo-gies, even with no history of cervical trauma.