A rare neurological association of bicuspid aortic valve: A case report

Abstract

A 45-year-old male presented to the Emergency Department with a 2-h history of sudden onset right-sided headache and difficulty walking. Initial non-contrast computed tomography (CT) of the brain was unremarkable. Twelve-lead electrocardiogram showed left ventricular (LV) hypertrophy with strain pattern. On echocardiography, the aortic valve was noted to be bicuspid, associated with at least moderate eccentric aortic regurgitation and moderate aortic stenosis. In view of the initial presentation of ataxia and headaches, and the finding of bicuspid aortic valve (BAV) on echocardiography, an urgent CT of aorta and carotid arteries was performed, revealing dissection of the right vertebral artery and a right lateral medullary infarct. Aortic root dilatation and aortic dissection are well known complications of BAV. However, vertebral artery dissection in the context of BAV with a normal aortic root is unusual, and to our knowledge has only been reported once in the literature so far.

Keywords

Bicuspid aortic valve / Vertebral artery dissection / Ataxia / Aorta / Congenital heart disease

Acknowledgments

None.

Funding

None.

Conflict of interest

The authors declare that they have no competing interests.

Author contributions

Conceptualization: Rachel A. Xuereb, John Bonello

Investigation: Maria J. Bonello, Gabriel Galea

Writing - original draft: Rachel A. Xuereb

Writing - review & editing: John Bonello, Robert G. Xuereb

Ethics approval and consent to participate

Verbal informed consent of the patient was obtained prior to participation.

Consent for publication

Verbal informed consent of the patient obtained for releasing his findings and data in this paper.

Availability of data

Not applicable.

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