A 28-year-old female presents to the emergency department with an occipital headache and neck pain. She mentions her symptoms appeared after hyperextending her neck while playing tennis the day before. Examination reveals dysdiadochokinesia and decreased lateral vision. A contrast head and neck CT demonstrate the findings seen here. Based on this patient’s probable diagnosis, which of the following treatments is most appropriate?
A. Surgical consultation
B. COX-2 inhibitor
C. Observation
D. Antithrombotic therapy
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Surgical Consultation. Possible fracture of the cervical bone resulting in occlusion of one of the arteries (vertebral?), hence requiring surgical replacement of the bone. Lack of blood flow to cerebellum and occipital lobe could possible explain the loss in vision and dysdiadokinesia.