Which of the following is NOT one of the "5 D's and 3 N's" indicative of potential vertebral artery dissection?

• A. Diplopia
• B. Dysarthria
• C. Vomiting
• D. Nystagmus

Answer: (C)

In the context of vertebral artery dissection, the "5 D's and 3 N's" represent a specific set of clinical signs and symptoms that suggest potential involvement of the vertebrobasilar system. The "5 D's" refer to Diplopia (double vision), Dysarthria (difficulty articulating words), Dysphagia (difficulty swallowing), Dizziness (specific types such as vertigo), and Drop attacks (sudden loss of strength). The "3 N's" involve Nystagmus (involuntary eye movements), Nausea, and Neck pain.

Among the choices provided, vomiting does not fit into this established clinical classification. While nausea is included in the "3 N's," vomiting is generally considered a symptom that can arise from a variety of conditions, including but not limited to vestibular disturbances or increased intracranial pressure. Thus, vomiting is not specifically indicative of vertebral artery dissection as per the "5 D's and 3 N's," making it the correct answer in identifying which symptom is not associated with this condition.