On February 18, 2006, I suffered a dissection of the left vertebral
in the back of the neck, leading to two strokes in the cerebellum. As
dissection did not happen in the aorta, I hesitate to submit my case
excellent website. However, I thought I would write to you about my
I am Chinese, male, and 54 years old. I was in good health. About 2
years ago, I had a stress test, which came out well. This morning my
115/81 and blood sugar was 121 mg/dl (fasting). I am 5’ 9” and 180
(I’m “big boned” and not fat.) I have never smoked and do not drink
alcohol. I am diabetic Type 2.
Back in mid-February I was breaking and cutting wood for firewood in
backyard in frigid weather. I have cut wood many times before. But
time, I came inside the house and experienced severe vertigo and then
up. According to the doctors, what I suffered was a vertebral
a blood vessel in the back of the neck. It led to two clogs in the
left sides of the cerebellum and strokes. It landed me in one
about 5 days. The hospital released me, but then next day I suffered
extreme headache (due to hemorrhaging in the brain) and I stayed at
hospital for more days.
I was discharged from the second hospital a little more than 2 months
The doctors believe that the dissection was due to the physical
swinging a heavy mallet. The doctors do not want me to lift anything
or get a neck massage or get any chiropractic manipulation on the
carry a backpack from now on.
I am under the care of 2 doctors. I am on disability leave from work
recovering at home. The doctors say it will take about 3-6 months
Feb) for the dissection to heal. I am taking baby aspirin (81 gm)
I have several questions:
1. Is my case of vertebral dissection rare, since most dissections
the aorta and carotid arteries? Have you heard of cases of vertbral
2. Was physical exertion the cause of the dissection? I have cut wood
times and engage in many types of physical exertion before? Certainly
other people have performed heavier physical exercise than I have.
3. I have had persistent headaches for long periods since the stroke.
have gone away for 2 weeks. They are relatively mild, about a 0.5 to
the pain scale. The doctors do not know why I have gotten these
Do you have any idea of why?
Thanks. I look forward to any ideas you might have. Thank you very
for your outstanding website.
Answers to Questions:
I'm not an expert on vertebral dissections so take what I say with a
heavy dose of skepticism.
Vertebral dissections as you correctly state are fairly rare. They
have been described in association with chiropractic manipulation or
other abrupt distortions of the neck. Whether the wood chopping had
anything to do with the dissection is hard to say with any certainty. It
is temporally correlated and the rise in blood pressure due to the
exertion may have been the final straw, but I would have to suspect that
there was some other inherent weakness in the artery that set the stage
for this. The other possibility especially if the dissection started
lower in the vertebral artery is that motion of lifting the arms
strenuously overhead to raise the ax may have started the tear. The
vertebral arteries arise form the subclavian artery which is the artery
that feeds the arm The sibclavian passes close to the clavicle, so
perhaps as you were cutting the wood the clavicle pulled or pinched the
vertebral as it was originating form the subclavian artery. Perhaps the
anatomy of how your vertebral takes-off from the sibclavian may have
place dyo at risk.
In any case the recommendation to stay away from chiropractors and
wood chopping probably make sense. whether all strenuous activities need
to be avoided is less clear. Certainly until your neuroligic symptoms
have resolved it makes sense.
Headaches after an intracranial bleed is not uncommon. They should
subside over time.
John Wong, Ph.D.