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Cervical artery dissection — SCE Neurology MCQ

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HardStrokeCervical artery dissectionSCE Neurology

A 39-year-old man has occipital headache and vertigo two days after minor neck trauma during football. Examination shows right Horner syndrome, dysarthria and ipsilateral limb ataxia. MRI confirms lateral medullary infarction. CT angiography shows tapered narrowing of the right vertebral artery. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Vertebral artery dissection

The best answer is “Vertebral artery dissection”. UK stroke guidance supports urgent vascular imaging and reperfusion selection, short-course dual antiplatelet therapy for eligible minor stroke or high-risk TIA, decompression for life-threatening swelling, and secondary prevention matched to mechanism. The alternatives “Cerebral venous sinus thrombosis”, “Vestibular neuritis”, “Posterior fossa tumour”, “Basilar migraine” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/