WARNING: Conducting an Orchestra Can Cause Vertebral Artery Dissection:
"Ostrich Sign" Indicates Bilateral Vertebral Artery Dissection
Journal of Stroke and Cerebrovascular Diseases 2011 (Mar 24) [Epub ahead of print]
Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms.
Vertebral Artery Injury in Cervical Spine Surgery:
Anatomical Considerations, Management, and Preventive Measures
Spine J. 2009 (Jan-Feb); 9 (1): 70–76
Vertebral artery (VA) injury can be a catastrophic iatrogenic complication of cervical spine surgery. Although the incidence is rare, it has serious consequences including fistulas, pseudoaneurysm, cerebral ischemia, and death. It is therefore imperative to be familiar with the anatomy and the instrumentation techniques when performing anterior or posterior cervical spine surgeries.