Spontaneous dissection of bilateral internal carotid and vertebral arteries

2021 ◽  
Vol 14 (3) ◽  
pp. e241173
Author(s):  
Amr Ewida ◽  
Rashid Ahmed ◽  
Anqi Luo ◽  
Hesham Masoud
Keyword(s):  
Weight Loss ◽  
Internal Carotid ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Review Of Literature ◽  
Vertebral Arteries ◽  
Ischaemic Attack ◽  
Middle Aged Adults ◽  
Spontaneous Dissection ◽  
Carotid And Vertebral Arteries

Spontaneous dissection of the major arteries of the neck is known to increase the risk of stroke or transient ischaemic attack in young and middle-aged adults. Most of the reported cases of arterial dissections in the neck involve one or both paired extracranial carotid or vertebral arteries. Spontaneous dissection of the bilateral internal carotid and vertebral arteries is extremely rare. We report a case of spontaneous bilateral internal carotid artery and vertebral artery dissection while using a prescribed pill for weight loss which contained amphetamine derivative. A review of literature is also provided.

scholarly journals Spontaneous cervical artery dissection: an update on clinical and diagnostic aspects

2008 ◽  
Vol 66 (4) ◽  
pp. 922-927 ◽  
Author(s):  
Cynthia Resende Campos-Herrera ◽  
Milberto Scaff ◽  
Fábio Iuji Yamamoto ◽  
Adriana Bastos Conforto
Keyword(s):  
Clinical Features ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Current Treatment ◽  
Vascular Lesion ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Vertebral Arteries ◽  
Internal Carotid Arteries ◽  
Carotid And Vertebral Arteries

Spontaneous cervical arterial dissection (SCAD) is a non-traumatic tear or disruption in the wall of the internal carotid arteries or the vertebral arteries. It accounts for about 25% of strokes in patients aged under 45 years. Awareness of its clinical features and advances in imaging over the last two decades have contributed to earlier identification of this condition. SCAD has become the commonest form of vascular lesion identified in the cervical carotid and vertebral arteries, second only to atherosclerosis. This review is an update on the epidemiology, vulnerable arterial segments, risk factors, clinical features, diagnosis, current treatment and prognosis of SCAD.

scholarly journals Predisposing factors and radiological features in patients with internal carotid artery dissection or vertebral artery dissection

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yongjun Wu ◽  
Hongbin Chen ◽  
Shihui Xing ◽  
Shuangquan Tan ◽  
Xinran Chen ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Vertebral Artery Dissection ◽  
Carotid Artery Dissection ◽  
Predisposing Factors ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Internal Carotid Artery Dissection ◽  
Radiological Features ◽  
Cervicocerebral Artery Dissection

Abstract Background Cervicocerebral artery dissection is an important cause of ischemic stroke in young and middle-aged individuals. However, very few studies have compared the differential features between internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD), including both cervical and intracranial artery dissections. We conducted a study to investigate the predisposing factors and radiological features in patients with ICAD or VAD. Methods All cases diagnosed with cervicocerebral artery dissection, ICAD, or VAD were identified through a medical records database, between January 2010 and January 2020. Baseline characteristics, predisposing factors, and radiological features of ICAD versus VAD were compared. Results A total of 140 patients with cervicocerebral artery dissection were included in the study, including 84 patients in the ICAD group and 56 in the VAD group. The mean age of patients in the ICAD and VAD groups was 43.37 ± 14.01 and 41.00 ± 12.98 years old, respectively. Patients with ICAD were more likely to be men compared with VAD (85.71% vs. 67.86%, p = 0.012). The frequency of hypertension, diabetes, smoking, drinking, and cervical trauma did not differ between ICAD and VAD. Dissections of ICAD were more frequently at the extracranial portions of the artery compared with those of VAD (70.24% vs. 44.64%, p = 0.003). In contrast, dissections of VAD were more common in the intracranial artery (55.36% vs. 29.76%, p = 0.003). Radiologically, double lumen (36.90% vs. 19.64%, p = 0.029) and intimal flap (11.90% vs. 1.79%, p = 0.029) were more frequently observed in ICAD than in VAD, and dissecting aneurysms were less frequent (13.10% vs. 26.79%, p = 0.041). Conclusions The distributions of cervical and intracranial artery dissections were different between ICAD and VAD. The frequencies of radiological features detected in patients with ICAD and VAD also differed.

scholarly journals Tissue Plasminogen Activator in a Vertebral Artery Dissection

1997 ◽  
Vol 24 (2) ◽  
pp. 151-157
Author(s):  
Andrew P. Gasecki ◽  
Carmelo Graffagnino ◽  
Vladimir Hachinski ◽  
J.P Bahary
Keyword(s):  
Vertebral Artery ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Neurological Signs ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Spontaneous Dissection

ABSTRACT:Background:Spontaneous dissection of the vertebral artery is uncommon.Method:Case study.Results:We report a 49-year-old woman who presented with the rapidly progressing basilar artery syndrome who was given an intravenous dose of tissue plasminogen activator seven hours after the onset of first symptoms. Thirty minutes after the injection, a dramatic recovery of the patient's consciousness and neurological signs was noted.Conclusion:To our knowledge, this is the first reported case of intravenous tissue plasminogen activator use in acute vertebral artery dissection.

Incompetent Circle of Willis and Vertebrobasilar Insufficiency

2003 ◽  
Vol 112 (8) ◽  
pp. 657-664 ◽  
Author(s):  
Louis W. Welsh ◽  
Bernard Lewin ◽  
John J. Welsh ◽  
Joseph E. Dragonette
Keyword(s):  
Internal Carotid ◽  
Circle Of Willis ◽  
Structural Defects ◽  
Vertebrobasilar Insufficiency ◽  
Resonance Imaging ◽  
Vertebral Arteries ◽  
Significant Difference ◽  
Asymptomatic Individuals ◽  
The Relationship ◽  
Carotid And Vertebral Arteries

An analysis of the vascular basis of vertebrobasilar insufficiency was derived from the examination of 135 subjects by magnetic resonance imaging and angiography. The data from this cohort were compared to those from normal, ie, asymptomatic, individuals. We concluded that there is a significant difference in the potential for intracerebral collateralization and regional perfusion due to structural defects such as stenosis or developmental absence of the posterior communicating arteries in this symptomatic group. In addition, an occlusion of one or more of the source vessels, the internal carotid and vertebral arteries, in conjunction with an incomplete circle of Willis increased the potential for hindbrain perfusion deficits. Clinical cases illustrate the relationship between failure of internal shunting and the myriad symptoms of hindbrain dysfunction.

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