Endovascular treatment with tirofiban during the acute stage of cervical spinal cord infarction due to vertebral artery dissection

Context: Cervical spinal cord infarction is a rare and severe complication of vertebral artery dissection (VAD). We report a case of VAD in an acute stage followed by cervical spinal cord infarction that was treated using direct endovascular tirofiban infusion via digital subtraction angiography (DSA) monitoring.Findings: A 48-year-old man presented with vertigo, neck pain, numbness and weakness in four limbs with subsequent cardiac and respiratory arrest. Neurological examination revealed hypoesthesia below the neck with grade one myodynamia on the right side of the limbs and zero on the left side. The diagnosis of VAD-related cervical spinal infarction was confirmed using DSA imaging and cervical vertebra magnetic resonance imaging (MRI). The patient received timely treatment with endovascular tirofiban infusion and achieved good outcome without any sequelae.Conclusion: Endovascular treatment with tirofiban may be a selective choice for cervical spinal cord infarction due to VAD in acute stage and warrants further study.