scholarly journals Medical and Interventional Therapy for Spontaneous Vertebral Artery Dissection in the Craniocervical Segment

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Guiyun Zhang ◽  
Zuoquan Chen
Keyword(s):  
Ischemic Stroke ◽  
Vertebral Artery ◽  
Conservative Therapy ◽  
Vertebral Artery Dissection ◽  
Clinical Manifestations ◽  
Interventional Therapy ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Stroke In The Young ◽  
Ischemic Attack

Background and Purpose. Spontaneous vertebral artery dissection (SVAD) is an important reason for posterior-circulation-ischemic stroke in the young and middle-aged population. Although some previous reports reveal a favorable outcome with conservative therapy, it is still controversial in the treatment of SVAD in some specific patients. Herein, we present our 10 years of clinical experience for SVAD at this location. Material and Methods. 20 patients with 20 SVADs in V2 and V3 segments were retrospectively studied. Clinical manifestations and imageology materials were collected and analyzed. All the patients underwent anticoagulation except for one patient because of contraindication. 14 patients underwent Wingspan stents implantation with general anesthesia. Results. In our sample, ischemia (infarction or transient ischemic attack, TIA) was found in all the patients. Angiographic stenosis and dissection aneurysm were the most common findings in the segments mentioned above. 19 of the patients (95%) got the excellent imageological and clinical outcomes. Conclusions. According to our experience in this group, although anticoagulation is effective in vertebral artery dissection, interventional therapy for SVADs in V2 and/or V3 segments is preferred in some specific patients. Stent with higher radial supporting and flexibility, such as Wingspan stent, is suggested.

Abstract TP84: Prognostic Factor of Intracranial Vertebral Artery Dissection: High Resolution Vessel Wall Magnetic Resonance Imaging Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jae-Hwan Kim ◽  
Hyung Jun Kim ◽  
Ye Sel Kim ◽  
Woo-Keun Seo ◽  
Oh Young Bang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
High Resolution ◽  
Prognostic Factor ◽  
Vertebral Artery ◽  
Vessel Wall ◽  
Independent Predictor ◽  
Vertebral Artery Dissection ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Poor Outcomes

Background: Vertebral artery dissection (VAD) is well recognized cause of stroke in young and middle aged individuals. But, prognostic factor of posterior circulation ischemic stroke or transient ischemic attack (TIA) caused by intracranial VAD has been rarely discussed. Our aim was to evaluate the predictors of poor outcomes in posterior circulation ischemic stroke caused by intracranial VAD. Methods: We retrospectively reviewed patients with posterior circulation ischemic stroke or TIA caused by intracranial VAD using high-resolution vessel wall MRI who were recruited from Samsung Medical Center Stroke Registry (between January 1, 2011 and April 30, 2019). Poor outcomes were defined as a 3-months modified Rankin scale (mRS) score ≥ 2. Results: We registered 96 patients (74 males; mean age, 58.9±14.2 years) with acute posterior circulation ischemic stroke or TIA caused by intracranial VAD. Trauma history associated with VAD was presented in 23 (24%) of patients. Headache and neck pain around neurological symptom onset were presented in 41 (42.7%) and 19 (19.8%) of patients, respectively. Dissecting aneurysm, bilateral vertebral artery involvement, basilar artery involvement and wall hematoma with dissection were presented in 26 (27.1%), 26 (27.1%), 12 (12.5%) and 66 (68.8%) of patients, respectively. Of the 96 VADs, 26 (27.1%) presented with focal stenosis, 21 (21.9%) with multifocal stenosis, and 57 (59.4%) with occlusion. Lateral medulla involvement and multiple territory involvement were presented in 35 (36.5%) and 31 (32.3%) of patients. Recurrence rate of ischemic stroke or TIA within 90 days of symptom onset was 6.25%. Twenty-nine patients (30.2%) had poor outcomes at 3 months. Lateral medulla involvement was an independent predictor for poor outcome (odds ratio=3.293, 95% confidence interval=1.301-8.333, p=0.012). Conclusion: Posterior circulation ischemic stroke or TIA caused by intracranial VAD is associated with relatively benign clinical course. But the presence of lateral medulla involvement is independent predictor for poor outcome. Patients presenting lateral medullary infarction caused by intracranial VAD should be monitored closely.

scholarly journals COVID-19 INFECTION IN A PATIENT WITH LUPUS PROGRESSING TO VERTEBRAL ARTERY DISSECTION AND ISCHEMIC STROKE

2021 ◽  
Author(s):  
Raiza Cansian Tuão ◽  
Paula dos Santos Athayde ◽  
Ketty Lysie Libardi Lira Machado ◽  
Bárbara Ferraço Dalmaso ◽  
Gustavo Pinto de Oliveira Gomes ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection

scholarly journals Diagnosis of vertebral artery dissection in childhood posterior circulation arterial ischaemic stroke

2015 ◽  
Vol 58 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Nadine McCrea ◽  
Dawn Saunders ◽  
Emmanouil Bagkeris ◽  
Manali Chitre ◽  
Vijeya Ganesan
Keyword(s):  
Ischaemic Stroke ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Arterial Ischaemic Stroke

scholarly journals Vertebral Artery Dissection Related to Amphetamine Abuse – A Case Report

2020 ◽  
Vol 12 ◽  
pp. 117957352093934
Author(s):  
Frederik Winsløw ◽  
Nadja Skadkær Hansen ◽  
Michael Broksgaard Jensen
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cerebral Magnetic Resonance Imaging ◽  
Amphetamine Abuse ◽  
Increased Risk ◽  
Stroke In The Young ◽  
Computed Tomography Angiogram ◽  
Neck Vessels

We report the case of a 37-year-old male patient with chronic amphetamine abuse who presented with vertebral artery dissection. Prior to presentation, he had increased the consumption of amphetamine from 5 times a year to once every week and had used amphetamine on the day of presentation. He attended with neck pain, vertigo and coordinating difficulties of his left arm. Computed tomography angiogram of the neck vessels showed a left vertebral stenosis and cerebral magnetic resonance imaging showed a left vertebral pseudolumen and a medullary stroke. Cervical artery dissection is a major cause of stroke in the young. To the authors’ knowledge, this is the second reported case of vertebral artery dissection in a patient with amphetamine abuse. Amphetamine might contribute to an increased risk of vertebral artery dissection through its vasculopathic properties although more data are needed to establish a causal relationship.

scholarly journals Combined thrombolysis in posterior circulation stroke caused by bilateral vertebral artery dissection in squash player

2014 ◽  
Vol 48 (4) ◽  
pp. 299-304 ◽  
Author(s):  
Emilia Frankowska ◽  
Krzysztof Brzozowski ◽  
Jacek Staszewski ◽  
Norbert Kolmaga ◽  
Adam Stępień ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Posterior Circulation Stroke

scholarly journals Oral Anticoagulant and Antiplatelet Therapy for Cervical Artery Dissection: A Meta-Analysis of Clinical Trials

2021 ◽  
Vol 27 ◽  
pp. 107602962110517
Author(s):  
Sheng-Lin Ye ◽  
Chuang Wang ◽  
Lu-Lu Wang ◽  
Tian-Ze Xu ◽  
Xiao-Qiang Li ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Ischemic Stroke ◽  
Vertebral Artery ◽  
Antiplatelet Therapy ◽  
Meta Analysis ◽  
Antiplatelet Agents ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Curative Effect ◽  
Ischemic Attack

Carotid and vertebral artery dissections are estimated to account for ∼20% of strokes in patients under 45-years-old. This meta-analysis compared the efficacy and safety of treatment with anticoagulants versus antiplatelet agents to determine the optimal therapy. We searched 4 electronic databases for clinical trials published from January 1, 1980 to August 25, 2021 that included patients who received anticoagulant or antiplatelet therapy for carotid and/or vertebral artery dissections. The curative effect was judged by recanalization evaluated by imaging. The primary outcomes were all cause death and ischemic stroke; secondary outcomes included hemorrhage and transient ischemic attack (TIA). Patients who received only a single drug treatment were divided into antiplatelet or anticoagulant groups; all received conservative treatment without surgical intervention. For this investigation, we pooled the available studies to conduct a meta-analysis, which included 7 articles with 1126 patients. The curative effect of vascular recanalization was not significantly different between the 2 treatment groups (odds ratio [OR] = 0.913, 95% confidence interval [CI]: 0.611-1.365, P = .657); similarly, no significant differences were found regarding the primary outcomes all cause death (OR = 1.747, 95%CI: 0.202-15.079, P = .612) and ischemic stroke (OR = 2.289, 95%CI: 0.997-5.254, P = .051). Patients treated with anticoagulants were more likely to experience TIA (OR = 0.517, 95%CI: 0.252-1.060, P = .072) and hemorrhage (OR = 0.468, 95%CI: 0.210-1.042, P = .063), but the differences were not statistically significant. Overall, there were no statistically significant differences between anticoagulant therapy and antiplatelet therapy for the treatment of carotid and vertebral artery dissections.

scholarly journals Vertebral Artery Dissection in a 7-year-old girl: A case report, pictorial review, and review of literature

2020 ◽  
Vol 5 (9) ◽  
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Vertebral Artery ◽  
Pediatric Population ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Review Of Literature ◽  
Arterial Ischemic Stroke ◽  
Pictorial Review ◽  
Imaging Recommendations

Vertebral artery dissection (VAD) is a not uncommon cause of arterial ischemic stroke in the pediatric population. Though it is frequently overlooked, and resources help in diagnosis often a concern, the establishment of diagnostic criteria is very crucial for treatment and prognosis. Here, we present a case of VAD with a pictorial and literature review, in addition to imaging recommendations.

scholarly journals Bilateral vertebral artery dissection complicated by posterior circulation stroke in a young man

Medicine ◽  
2020 ◽  
Vol 99 (44) ◽  
pp. e22822
Author(s):  
Zhichao Li ◽  
Junni Liu ◽  
Xiang Wang ◽  
Xiaohui Liu ◽  
Qinjian Sun ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Posterior Circulation Stroke
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