Delayed Diagnosis of Traumatic Vertebral Artery Dissection after La Tomatina Festival



We present the case of a 50-year-old patient who was repatriated to the UK following treatment for lateral medullary syndrome in Spain. On further imaging a vertebral artery dissection was discovered. After a review of the history, the patient revealed that on the day before his symptoms started, he attended La Tomatina, a tomato throwing festival. He reported that he was hit in the back of the neck several times by tomatoes. Previous injuries reported at La Tomatina do not include vertebral artery dissection.[1] The rules of the festival state that tomatoes should be crushed prior to throwing to prevent injury.[2] This case highlights the high index of suspicion required when patients present with posterior stroke symptoms. If the presentation is associated with an injury the onset can be delayed and the mechanism may not be immediately obvious. Further questioning may be required when a vertebral artery dissection diagnosis is suspected.

Keywords: Stroke, Neurology, Cranial Nerves

Citation: Wilson E, Abidakun O, Hindmarsh A. “Delayed Diagnosis of Traumatic Vertebral Artery Dissection after La Tomatina Festival”. SVOA Neurology 3:1 (2022) Pages 11-14.