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Dr. Andrew Rynne

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Does stroke lead to vertigo and pulsating sensation in the neck?

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Neurologist
Practicing since : 2004
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Question
im a 36 yr old female. last month i had a vertbral artery dissection that caused 5 strokes. they put me on 325 mg aspirin and lipitor.
lately ive been having vertigo and a slightly strong pulsating in my lower right neck. is this something to be worried about or what could be causing it?
i did have an electrocardiogram, holter monitor, ct, mri and angiogram done. all the heart ones turned out okay.
Tue, 17 Apr 2018 in Brain and Spine
 
 
Answered by Dr. Olsi Taka 35 minutes later
Brief Answer:
Possibility of a new stroke must be considered.

Detailed Answer:
I read your question carefully and I understand your concern.

The brain territory supplied by the vertebral artery is very much involved in balance. So it wouldn't be surprising if the strokes you had last month caused vertigo. However if due to those strokes it should have manifested at the time. If you had no vertigo until now, if it is a new symptom then it shouldn't be attributed to consequences of past stroke right away, other possibilities should be considered. The main possibility would be that of a new stroke happening, of a new blood clot due to the dissection. There is a possibility of recurrence which is why Aspirin is given, to try and prevent it (but it offers no guarantees). So I believe if appearing only now and there is no other cause to justify them (say dehydration, low blood pressure, some infection etc) then a re-evaluation and repeat imaging of the brain is recommended. Imaging of blood vessels is necessary as well to check for possibility of dilation of blood vessel wall at the dissection site (causing that pulsating feeling).

That being said I do not want you to panic, most recurrences are in the first week, the longer it goes the lower the likelihood of new strokes from happening as the arterial wall heals. So after more than a month the likelihood of a new stroke is low. But still new symptoms can't be neglected and evaluation is needed.

I remain at your disposal for other questions.
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