Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2019; 7(1): 73-78
Published online Jan 6, 2019. doi: 10.12998/wjcc.v7.i1.73
Vertebrobasilar artery dissection manifesting as Millard-Gubler syndrome in a young ischemic stroke patient: A case report
Xuan-Ting Li, Jun-Liang Yuan, Wen-Li Hu
Xuan-Ting Li, Jun-Liang Yuan, Wen-Li Hu, Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Author contributions: Li XT and Yuan JL are joint first authors. Hu WL designed the research; Li XT and Yuan JL collected the data; Li XT and Yuan JL wrote the paper.
Supported by the National Natural Science Foundation of China, No. 81301016; and the Beijing Municipal Administration of Hospitals’ Youth Programme, No. QML20150303.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen-Li Hu, MD, Director, Doctor, Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, No. 8, South Gongti Road, Chaoyang District, Beijing 100020, China. wenlihu3366@126.com
Telephone: +86-10-85231370 Fax: +86-10-85232985
Received: August 2, 2018
Peer-review started: August 3, 2018
First decision: October 19, 2018
Revised: November 23, 2018
Accepted: November 30, 2018
Article in press: December 1, 2018
Published online: January 6, 2019
Abstract
BACKGROUND

Millard-Gubler syndrome (MGS) is caused by a lesion in the brainstem at the level of the facial nerve nucleus, and it is also a rare ventral pontine syndrome. Vertebrobasilar artery dissection (VAD) is an uncommon cause of ischemic stroke. To the best of our knowledge, this is the first case report on the coexistence of MGS and VAD in a young acute ischemic stroke patient.

CASE SUMMARY

We herein describe an unusual case of young acute ischemic stroke patient, presenting with acute right peripheral facial palsy, right abducens palsy, and contralateral hemihypesthesia, manifesting as MGS. After receiving dual antiplatelet therapy with aspirin and clopidogrel, as well as rosuvastatin, the patient recovered significantly. The high-resolution magnetic resonance imaging (MRI) indicated a diagnosis of VAD.

CONCLUSION

Our finding further demonstrated that high-resolution MRI is a useful technique to early detect underlying dissection in posterior circulation ischemic stroke.

Keywords: Millard-Gubler syndrome, Vertebrobasilar artery dissection, Ischemic stroke, Case report

Core tip: Millard-Gubler syndrome (MGS) is caused by a lesion in the brainstem at the level of facial nerve nucleus, and it is also a rare ventral pontine syndrome. We herein describe an unusual case of young acute ischemic stroke patient presenting with MGS. The high-resolution magnetic resonance imaging (MRI) indicated a diagnosis of vertebrobasilar artery dissection (VAD). This is the first case report on the coexistence of MGS and VAD in a young acute ischemic troke patient. Our finding further demonstrated that high-resolution MRI is a useful technique to early detect underlying dissection in posterior circulation ischemic stroke.