{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:57:25Z","timestamp":1762005445203,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,12,24]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Vertebral artery dissections are a rare pathology that carries a high risk of stroke in a younger population. They may be caused by minor mechanisms and the index of suspicion should be high. Treatment with anticoagulation or antiplatelets should follow if no surgical management is indicated.<\/jats:p>\n               <jats:p>We describe a case of a female in her 30s who fell backward off a swing and rolled over her head and complained of continued posterior neck pain. The patient was found to have a vertebral artery dissection on MRI. The patient was then anticoagulated with high-dose apixaban and low-dose aspirin.<\/jats:p>\n               <jats:p>The emergency medicine provider should be aware of possible low-impact mechanisms that can cause vertebral artery dissection and should have a high index of suspicion. If surgical management is not indicated, anticoagulation should be initiated.<\/jats:p>","DOI":"10.1136\/bcr-2023-255923","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T01:11:20Z","timestamp":1704849080000},"page":"e255923","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Vertebral Artery Dissection"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4753-9612","authenticated-orcid":false,"given":"Ivan","family":"Ivanov","sequence":"first","affiliation":[{"name":"Emergency Department, New York City Health and Hospitals Coney Island, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Cataldo","sequence":"additional","affiliation":[{"name":"Emergency Department, New York City Health and Hospitals Coney Island, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa","family":"Cocchiara","sequence":"additional","affiliation":[{"name":"Emergency Department, New York City Health and Hospitals Coney Island, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalee","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Emergency Department, New York City Health and Hospitals Coney Island, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,9]]},"reference":[{"key":"2025082802072065000_17.1.e255923.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103223441206"},{"key":"2025082802072065000_17.1.e255923.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1862-y"},{"key":"2025082802072065000_17.1.e255923.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.9.1702"},{"key":"2025082802072065000_17.1.e255923.4","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1987.00520170009012"},{"key":"2025082802072065000_17.1.e255923.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1887-2"},{"key":"2025082802072065000_17.1.e255923.6","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/BSD.0b013e318141fce8","article-title":"Angiographic detection of carotid and vertebral arterial injury in the high-energy blunt trauma patient","volume":"21","author":"Hoit","year":"2008","journal-title":"Journal of Spinal Disorders & Techniques"},{"key":"2025082802072065000_17.1.e255923.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-001-0056-x"},{"key":"2025082802072065000_17.1.e255923.8","doi-asserted-by":"publisher","DOI":"10.1097\/NRL.0b013e31826754e1"},{"key":"2025082802072065000_17.1.e255923.9","doi-asserted-by":"crossref","first-page":"217","DOI":"10.21037\/jss.2017.05.10","article-title":"Blunt vertebral vascular injury in trauma patients: ATLS\u00ae recommendations and review of current evidence","volume":"3","author":"Shafafy","year":"2017","journal-title":"J Spine Surg"},{"key":"2025082802072065000_17.1.e255923.10","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2009.111"},{"key":"2025082802072065000_17.1.e255923.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-019-01677-0"},{"key":"2025082802072065000_17.1.e255923.12","first-page":"471","article-title":"Blunt cerebrovascular injury practice management guidelines: the Eastern Association for the surgery of trauma","volume":"68","author":"Bromberg","year":"2010","journal-title":"Journal of Trauma"},{"key":"2025082802072065000_17.1.e255923.13","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000098649.39767.BC"},{"key":"2025082802072065000_17.1.e255923.14","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200205000-00012"},{"key":"2025082802072065000_17.1.e255923.15","unstructured":"Simon LV , Mohseni M . Vertebral Artery Injury Treasure Island (FL): StatPearls Publishing, Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470363"},{"key":"2025082802072065000_17.1.e255923.16","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1097\/TA.0000000000003127","article-title":"Blunt cerebrovascular injuries: outcomes from the American Association for the surgery of trauma prospective observational vascular injury treatment (PROOVIT) multicenter Registry","volume":"90","author":"Russo","year":"2021","journal-title":"J Trauma Acute Care Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255923","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:07:31Z","timestamp":1756372051000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,9]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/bcr-2023-255923"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255923","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}