Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Advertisement

Hypertension Research
  • View all journals
  • Search
  • Log in
  • Content Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • RSS feed
  1. nature
  2. hypertension research
  3. case report
  4. article
A Case of Vertebral Artery Dissection Associated with Morning Blood Pressure Surge
Download PDF
Download PDF
  • Case Report
  • Published: 01 October 2005

A Case of Vertebral Artery Dissection Associated with Morning Blood Pressure Surge

  • Kazuo Eguchi1,2,
  • Yuichi Tachikawa3,
  • Ryuichi Kashima1,
  • Michi Shinohara1,
  • Fumiya Fukushima1,
  • Takashi Sato1,
  • Akira Takeda1,
  • Toshio Numao1,
  • Kazuomi Kario2 &
  • …
  • Kazuyuki Shimada2 

Hypertension Research volume 28, pages 847–851 (2005)Cite this article

  • 4317 Accesses

  • Metrics details

Abstract

We report a case of a middle-aged man who suffered a cerebral infarction resulting from dissection of a vertebral artery associated with morning blood pressure surge. A 56-year-old man was transferred to our hospital with dizziness and vomiting in the early morning on a cold day in winter. He reported that he had been standing in front of the sink after bathing when he suddenly felt dizzy and fell down. He did not lose consciousness, and by the time he reached the hospital by ambulance, his dizziness had subsided, but he complained of severe headache and vomited 3 times. On admission, he was alert, and there were no neurological or radiological abnormalities (CT, MR angiography) in the brain. However, infarction in the left cerebellar hemisphere was detected by brain MRI on the 5th day of hospitalization. String sign of the left vertebral artery was noted by angiography, confirming the diagnosis of dissection of the left vertebral artery. Ambulatory blood pressure monitoring was performed after discharge. Although the mean 24-h blood pressure was in the normal range, a marked morning blood pressure rise was observed. We speculated that the acute rise of blood pressure in the early morning might have contributed to the dissection of the vertebral artery.

Similar content being viewed by others

Early arterial pressure monitoring and term-equivalent age MRI findings in very preterm infants

Article 19 November 2021

Burden of cerebral small vessel disease and changes of diastolic blood pressure affect clinical outcome after acute ischemic stroke

Article Open access 12 December 2023

Cervical spinal cord infarction due to impingement of an anomalous right vertebral artery by thoracic osteophyte

Article 28 October 2021

Article PDF

References

  1. Haldeman S, Kohlbeck FJ, McGregor M : Risk factors and precipitating neck movements causing vertebrobasilar artery dissection after cervical trauma and spinal manipulation. Spine 1999; 24: 785–794.

    Article  CAS  Google Scholar 

  2. Yamaura A, Ono J, Hirai S : Clinical picture of intracranial non-traumatic dissecting aneurism. Neuropathology 2000; 1: 85–90.

    Article  Google Scholar 

  3. Hosoya T, Adachi M, Yamaguchi K, Haku T, Kayama T, Kato T : Clinical and neuroradiological features of intracranial vertebrobasilar artery dissection. Stroke 1999; 30: 1083–1090.

    Article  CAS  Google Scholar 

  4. Sasaki O, Ogawa H, Koike T, Koizumi T, Tanaka R : A clinicopathologic study of dissecting aneurysms of the intracranial vertebral artery. J Neurosurg 1991; 75: 874–882.

    Article  CAS  Google Scholar 

  5. Takahashi I, Kaneko S, Asaoka K, Harada T : A case of Bow Hunter's stroke. No To Shinkei 1994; 46: 183–187.

    CAS  PubMed  Google Scholar 

  6. Ishizaka N, Ishizaka Y, Toda E, Hashimoto H, Nagai R, Yamakado M : Hypertension is the most common component of metabolic syndrome and the greatest contributor to carotid arteriosclerosis in apparently healthy Japanese individuals. Hypertens Res 2005; 28: 27–34.

    Article  Google Scholar 

  7. Yamagishi K, Iso H, Kitamura A, et al: Smoking raises the risk of total and ischemic strokes in hypertensive men. Hypertens Res 2003; 26: 209–217.

    Article  Google Scholar 

  8. Eguchi K, Kario K, Hoshide S, et al: Smoking is associated with silent cerebrovascular disease in a high-risk Japanese community-dwelling population. Hypertens Res 2004; 27: 747–754.

    Article  Google Scholar 

  9. Kawasaki T, Uezono K, Sanefuji M, et al: A 17-year follow-up study of hypertensive and normotensive male university students in Japan. Hypertens Res 2003; 26: 445–452.

    Article  Google Scholar 

  10. Fujii K, Abe I, Ohya Y, et al: Risk factors for the progression of early carotid atherosclerosis in a male working population. Hypertens Res 2003; 26: 465–471.

    Article  Google Scholar 

  11. Matsui Y, Kario K, Ishikawa J, Eguchi K, Hoshide S, Shimada K : Reproducibility of arterial stiffness indices (pulse wave velocity and augmentation index) simultaneously assessed by automated pulse wave analysis and their associated risk factors in essential hypertensive patients. Hypertens Res 2004; 27: 851–857.

    Article  Google Scholar 

  12. Hoshide S, Kario K, Eguchi K, Ishikawa J, Morinari M, Shimada K : Altered aortic properties in elderly orthostatic hypertension. Hypertens Res 2005; 28: 15–19.

    Article  Google Scholar 

  13. Yambe M, Tomiyama H, Hirayama Y, et al: Arterial stiffening as a possible risk factor for both atherosclerosis and diastolic heart failure. Hypertens Res 2004; 27: 625–631.

    Article  Google Scholar 

  14. Okamura T, Moriyama Y, Kadowaki T, Kanda H, Ueshima H : Non-invasive measurement of brachial-ankle pulse wave velocity is associated with serum C-reactive protein but not with α-tocopherol in Japanese middle-aged male workers. Hypertens Res 2004; 27: 173–180.

    Article  CAS  Google Scholar 

  15. Imanishi R, Seto S, Toda G, et al: High brachial-ankle pulse wave velocity is an independent predictor of the presence of coronary artery disease in men. Hypertens Res 2004; 27: 71–78.

    Article  Google Scholar 

  16. Nakamura U, Iwase M, Nohara S, Kanai H, Ichikawa K, Iida M : Usefulness of brachial-ankle pulse wave velocity measurement: correlation with abdominal aortic calcification. Hypertens Res 2003; 26: 163–167.

    Article  Google Scholar 

  17. Kario K, Pickering TG, Umeda Y, et al: Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation 2003; 107: 1401–1406.

    Article  Google Scholar 

  18. Ikeda T, Gomi T, Shibuya Y, et al: Morning rise in blood pressure is a predictor of left ventricular hypertrophy in treated hypertensive patients. Hypertens Res 2004; 27: 939–946.

    Article  Google Scholar 

  19. Kawano Y, Abe H, Kojima S, Takishita S, Matsuoka H : Effects of repeated alcohol intake on blood pressure and sodium balance in Japanese males with hypertension. Hypertens Res 2004; 27: 167–172.

    Article  CAS  Google Scholar 

  20. Kurihara T, Tomiyama H, Hashimoto H, Yamamoto Y, Yano E, Yamashina A : Excessive alcohol intake increases the risk of arterial stiffening in men with normal blood pressure. Hypertens Res 2004; 27: 669–673.

    Article  Google Scholar 

  21. Kario K, Shimada K : Differential effects of amlodipine on ambulatory blood pressure in elderly hypertensive patients with different nocturnal reductions in blood pressure. Am J Hypertens 1997; 10: 261–268.

    Article  CAS  Google Scholar 

  22. Pickering TG, Davidson K, Gerin W, Schwartz JE : Masked hypertension. Hypertension 2002; 40: 795–796.

    Article  CAS  Google Scholar 

  23. Tachibana R, Tabara Y, Kondo I, Miki T, Kohara K : Home blood pressure is a better predictor of carotid atherosclerosis than office blood pressure in community-dwelling subjects. Hypertens Res 2004; 27: 633–639.

    Article  Google Scholar 

  24. Eguchi K, Kario K, Hoshide S, et al: Greater change of orthostatic blood pressure is related to silent cerebral infarct and cardiac overload in hypertensive subjects. Hypertens Res 2004; 27: 235–241.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Shioya General Hospital, Tochigi, Japan

    Kazuo Eguchi, Ryuichi Kashima, Michi Shinohara, Fumiya Fukushima, Takashi Sato, Akira Takeda & Toshio Numao

  2. Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical School, Tochigi, Japan

    Kazuo Eguchi, Kazuomi Kario & Kazuyuki Shimada

  3. Department of Neurosurgery, Shioya General Hospital, Tochigi, Japan

    Yuichi Tachikawa

Authors
  1. Kazuo Eguchi
    View author publications

    Search author on:PubMed Google Scholar

  2. Yuichi Tachikawa
    View author publications

    Search author on:PubMed Google Scholar

  3. Ryuichi Kashima
    View author publications

    Search author on:PubMed Google Scholar

  4. Michi Shinohara
    View author publications

    Search author on:PubMed Google Scholar

  5. Fumiya Fukushima
    View author publications

    Search author on:PubMed Google Scholar

  6. Takashi Sato
    View author publications

    Search author on:PubMed Google Scholar

  7. Akira Takeda
    View author publications

    Search author on:PubMed Google Scholar

  8. Toshio Numao
    View author publications

    Search author on:PubMed Google Scholar

  9. Kazuomi Kario
    View author publications

    Search author on:PubMed Google Scholar

  10. Kazuyuki Shimada
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Kazuomi Kario.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eguchi, K., Tachikawa, Y., Kashima, R. et al. A Case of Vertebral Artery Dissection Associated with Morning Blood Pressure Surge. Hypertens Res 28, 847–851 (2005). https://doi.org/10.1291/hypres.28.847

Download citation

  • Received: 06 June 2005

  • Accepted: 28 July 2005

  • Issue date: 01 October 2005

  • DOI: https://doi.org/10.1291/hypres.28.847

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Keywords

  • vertebral artery dissection
  • morning blood pressure surge
  • cerebellar infarction

This article is cited by

  • Vertebral artery dissection in hypertensive disorders of pregnancy: a case series and literature review

    • Renuka Shanmugalingam
    • Nina Reza Pour
    • Angela Makris

    BMC Pregnancy and Childbirth (2016)

  • Effects of Antihypertensive Therapy on Blood Pressure Variability

    • Kazuo Eguchi

    Current Hypertension Reports (2016)

  • Towards understanding seasonal variability in cervical artery dissection (CeAD)

    • Manja Kloss
    • Antti Metso
    • Stefan T. Engelter

    Journal of Neurology (2012)

Download PDF

Advertisement

Explore content

  • Research articles
  • Reviews & Analysis
  • News & Comment
  • Current issue
  • Collections
  • Sign up for alerts
  • RSS feed

About the journal

  • Journal Information
  • Open Access Fees and Funding
  • Guide to Authors
  • About the Editors
  • Message from Editors
  • Call for Paper
  • Contact
  • About the Partner
  • For Advertisers
  • Subscribe
  • Showcase of Graphical Abstracts on Hypertension Research

Publish with us

  • For Authors & Referees
  • Language editing services
  • Open access funding
  • Submit manuscript

Search

Advanced search

Quick links

  • Explore articles by subject
  • Find a job
  • Guide to authors
  • Editorial policies

Hypertension Research (Hypertens Res)

ISSN 1348-4214 (online)

ISSN 0916-9636 (print)

nature.com sitemap

About Nature Portfolio

  • About us
  • Press releases
  • Press office
  • Contact us

Discover content

  • Journals A-Z
  • Articles by subject
  • protocols.io
  • Nature Index

Publishing policies

  • Nature portfolio policies
  • Open access

Author & Researcher services

  • Reprints & permissions
  • Research data
  • Language editing
  • Scientific editing
  • Nature Masterclasses
  • Research Solutions

Libraries & institutions

  • Librarian service & tools
  • Librarian portal
  • Open research
  • Recommend to library

Advertising & partnerships

  • Advertising
  • Partnerships & Services
  • Media kits
  • Branded content

Professional development

  • Nature Awards
  • Nature Careers
  • Nature Conferences

Regional websites

  • Nature Africa
  • Nature China
  • Nature India
  • Nature Japan
  • Nature Middle East
  • Privacy Policy
  • Use of cookies
  • Legal notice
  • Accessibility statement
  • Terms & Conditions
  • Your US state privacy rights
Springer Nature

© 2025 Springer Nature Limited