Which sign is associated with Vertebral Artery Dissection presenting after neck manipulation?

Which sign is associated with Vertebral Artery Dissection presenting after neck manipulation?

• A. Fever and neck stiffness
• B. Saddle anesthesia
• C. Sudden severe headache with Horner's syndrome (ptosis/miosis) after adjustment
• D. A tearing chest pain

Answer: (C)

Vertebral artery dissection after neck manipulation typically presents with a sudden, severe occipital or neck pain, and may be accompanied by signs of posterior circulation involvement. A classic accompanying finding is Horner's syndrome (ptosis and miosis) due to disruption of the sympathetic pathway as the dissection affects vessels near the brainstem. Fever with neck stiffness would point to meningitis, saddle anesthesia to cauda equina issues, and tearing chest pain to aortic dissection. So the combination that best fits this scenario is a sudden severe headache with Horner's syndrome occurring after the neck adjustment.

Vertebral artery dissection after neck manipulation typically presents with a sudden, severe occipital or neck pain, and may be accompanied by signs of posterior circulation involvement. A classic accompanying finding is Horner's syndrome (ptosis and miosis) due to disruption of the sympathetic pathway as the dissection affects vessels near the brainstem. Fever with neck stiffness would point to meningitis, saddle anesthesia to cauda equina issues, and tearing chest pain to aortic dissection. So the combination that best fits this scenario is a sudden severe headache with Horner's syndrome occurring after the neck adjustment.