scholarly journals Migraine, migraine aura, and cervical artery dissection: A systematic review and meta-analysis

Cephalalgia ◽  
2011 ◽  
Vol 31 (8) ◽  
pp. 886-896 ◽  
Author(s):  
Pamela M Rist ◽  
Hans-Christoph Diener ◽  
Tobias Kurth ◽  
Markus Schürks
Keyword(s):  
Systematic Review ◽  
Migraine With Aura ◽  
Meta Analysis ◽  
Current Evidence ◽  
Artery Dissection ◽  
Effect Estimate ◽  
Cervical Artery Dissection ◽  
Migraine Aura ◽  
Increased Risk ◽  
Cervical Artery

Objective: We evaluated the current evidence on the association between migraine, including aura status, and cervical artery dissection. Methods: We performed a systematic review and meta-analysis of studies investigating the association between migraine or migraine subtypes (e.g. migraine with aura) and cervical artery dissection published through October 2010. Results: We identified five case-control studies investigating the association between migraine and cervical artery dissection. In pooled analysis, migraine doubled the risk of cervical artery dissection (pooled odds ratio [OR] = 2.06, 95% confidence interval [CI] 1.33–3.19). All studies allowed evaluation of migraine aura status. While the effect estimate for migraine without aura (pooled OR = 1.94, 95% CI 1.21–3.10) was similar to overall migraine, the association was weaker for migraine with aura (pooled OR = 1.50, 95% CI 0.76–2.96). However, there is no evidence that aura status significantly modifies the association between migraine and cervical artery dissection (meta-regression on aura status p = .58). The risk does not appear to differ between women and men; however, only few studies presented gender-specific data. Heterogeneity among studies was low to moderate. Conclusion: In this meta-analysis migraine is associated with a two-fold increased risk of cervical artery dissection. This risk does not appear to significantly differ by migraine aura status or gender.

Micro-Embolic Signals and Dissection: Association or Causation for Stroke? A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-8
Author(s):  
Pachipala Sudheer ◽  
Deepti Vibha
Keyword(s):  
Systematic Review ◽  
Acute Stroke ◽  
Meta Analysis ◽  
Small Population ◽  
Cochrane Library ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Pooled Prevalence ◽  
Increased Risk ◽  
Embolic Signals

<b><i>Background and Objective:</i></b> Although the mechanism of stroke in cervical artery dissection (CAD) has been hypothesized to be embolization rather than hemodynamic compromise, there are a limited number of studies supporting this hypothesis. Detection of micro-embolic signals (MESs) using transcranial Doppler (TCD) helps in understanding the mechanism in these patients. A systematic review and meta-analysis were performed to estimate the prevalence of MES and its association with stroke outcomes in patients with acute stroke/TIA secondary to dissection. <b><i>Methods:</i></b> A comprehensive literature search was conducted for studies before January 26, 2021, in PubMed, Embase, Google Scholar, Cochrane Library, and ClinicalTrials.gov. Studies were identified that used TCD to detect MES in stroke/TIA patients secondary to CAD. Pooled prevalence was calculated. Entire statistical analysis was conducted in R version 3.6.2. <b><i>Results:</i></b> Eleven studies involving 112 patients (50 MES+, 62 MES−) were included in our meta-analysis. The pooled prevalence of MES among acute stroke/TIA patients secondary to dissection was 46.0% (95% CI 26.0–67.0%). The presence of MES was associated with an increased risk of early ischemic recurrence in patients with CAD. We could not estimate the functional outcome and mortality associated with the presence of MES due to the scarcity of data. <b><i>Conclusions:</i></b> Our meta-analysis showed 46% prevalence of MES in the studies which looked at acute stroke/TIA secondary to CAD using TCD. This finding supports the assumption that embolism may be a major cause of stroke in patients with dissection although this could be determined only in a small population.

scholarly journals Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation

Cureus ◽  
2016 ◽  
Author(s):  
Ephraim W Church ◽  
Emily P Sieg ◽  
Omar Zalatimo ◽  
Namath S Hussain ◽  
Michael Glantz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Chiropractic Care ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cervical Artery

Abstract WP12: Endovascular Thrombectomy for Acute Ischemic Stroke Associated With Cervical Artery Dissection: A Systematic Review and Meta-Analysis

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam A Dmytriw ◽  
Julian Maingard ◽  
Kevin Phan ◽  
Rajph J Mobbs ◽  
Mark Brooks ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Meta Analysis ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Endovascular Thrombectomy ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Cervical Artery

Objectives: Strokes associated with cervical artery dissection have been managed primarily with antithrombotics with poor outcomes. The additive role of endovascular thrombectomy remains unclear. The objective was to perform systematic review and meta-analysis to compare endovascular thrombectomy and medical therapy for acute ischemic stroke associated with cervical artery dissection. Methods: Studies from six electronic databases included outcomes of patient cohorts with acute ischemic stroke secondary to cervical artery dissection who underwent treatment with endovascular thrombectomy. A meta-analysis of proportions was conducted with a random-effects model. Modified Rankin score at 90 days (mRS 0-2) was the primary outcome. Other outcomes included proportion of patients with thrombolysis in cerebral infarction (TICI) 2b-3 flow, 90-day mortality rate, and 90-day symptomatic intracerebral hemorrhage (sICH) rate. Results: Six studies were included, comprising 193 cases that underwent thrombectomy compared with 59 cases that were managed medically. Successful recanalization with a pooled proportion of thrombolysis in cerebral infarction (TICI) 2b-3 flow in the thrombectomy group was 74%. Favorable outcome (mRS 0-2) was superior in the pooled thrombectomy group (62.9%, 95% CI 55.8-69.5%) compared medical management (41.5%, 95% CI 29.0-55.1%, P=0.006). The pooled rate of 90-day mortality was similar for endovascular vs medical (8.6% vs 6.3%). The pooled rate of symptomatic intracranial haemorrhage (sICH) did not significantly differ (5.9% vs 4.2%, P=0.60). Conclusions: Current data suggest that endovascular thrombectomy may be an option in patients with acute ischemic stroke due to cervical artery dissection. This requires further confirmation in higher quality prospective studies.

scholarly journals Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis

2021 ◽  
Author(s):  
Davide Bona ◽  
Francesca Lombardo ◽  
Kazuhide Matsushima ◽  
Marta Cavalli ◽  
Valerio Panizzo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Algorithm ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
Current Evidence ◽  
Esophageal Hiatus ◽  
Pooled Prevalence ◽  
Increased Risk ◽  
Esophagogastric Surgery

Abstract Introduction The anatomy of the esophageal hiatus is altered during esophagogastric surgery with an increased risk of postoperative hiatus hernia (HH). The purpose of this article was to examine the current evidence on the surgical management and outcomes associated with HH after esophagogastric surgery for cancer. Materials and methods Systematic review and meta-analysis. Web of Science, PubMed, and EMBASE data sets were consulted. Results Twenty-seven studies were included for a total of 404 patients requiring surgical treatment for HH after esophagogastric surgery. The age of the patients ranged from 35 to 85 years, and the majority were males (82.3%). Abdominal pain, nausea/vomiting, and dyspnea were the commonly reported symptoms. An emergency repair was required in 51.5%, while a minimally invasive repair was performed in 48.5%. Simple suture cruroplasty and mesh reinforced repair were performed in 65% and 35% of patients, respectively. The duration between the index procedure and HH repair ranged from 3 to 144 months, with the majority (67%) occurring within 24 months. The estimated pooled prevalence rates of pulmonary complications, anastomotic leak, overall morbidity, and mortality were 14.1% (95% CI = 8.0–22.0%), 1.4% (95% CI = 0.8–2.2%), 35% (95% CI = 20.0–54.0%), and 5.0% (95% CI = 3.0–8.0%), respectively. The postoperative follow-up ranged from 1 to 110 months (mean = 24) and the pooled prevalence of HH recurrence was 16% (95% CI = 13.0–21.6%). Conclusions Current evidence reporting data for HH after esophagogastric surgery is narrow. The overall postoperative pulmonary complications, overall morbidity, and mortality are 14%, 35%, and 5%, respectively. Additional studies are required to define indications and treatment algorithm and evaluate the best technique for crural repair at the index operation in an attempt to minimize the risk of HH.

scholarly journals Recurrence of cervical artery dissection: protocol for a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037124
Author(s):  
Elizabeth Lounsbury ◽  
Brian Dewar ◽  
Alexandra Davis ◽  
Dean A Fergusson ◽  
Dar Dowlatshahi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vertebral Artery Dissection ◽  
Primary Data ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cochrane Central Register ◽  
Minor Trauma ◽  
Central Register ◽  
Cervical Artery ◽  
Registration Number

IntroductionCervical artery dissection, including carotid and vertebral artery dissection, is an important cause of stroke in the young. Risk of developing cervical artery dissection has been associated with physical activity in various forms and has been presumed to be related to minor trauma and mechanical stretching of the cervical arteries. This systematic review will aim to synthesise data on the risk of recurrent cervical artery dissection after an initial dissection. This information may be applied to further understand the natural history of this disease, and potentially to help direct evidence-based discussions on safe return to activity after dissection.Methods and analysisA broad search of multiple electronic databases (Medline, Embase, Cochrane Central Register of Controlled Trials and Web of Science) will be conducted to identify studies published as of 13 November 2019, examining all-comers with cervical artery dissection observed over time. Studies will be screened by two independent reviewers in a two-level process to determine eligibility for inclusion. Data will be pooled from eligible articles and the main outcome of recurrent cervical artery dissection at 5 years will be determined using quantitative analysis.Ethics and disseminationEthics approval is not necessary as no primary data are being collected. The information will be disseminated in the form of a systematic review article which will be submitted to a peer-reviewed medical journal.PROSPERO registration numberCRD42020166105.

scholarly journals Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis

2019 ◽  
Vol 49 (07) ◽  
pp. 1057-1078 ◽  
Author(s):  
Ioannis Angelakis ◽  
Emma Louise Gillespie ◽  
Maria Panagioti
Keyword(s):  
Systematic Review ◽  
Childhood Abuse ◽  
Childhood Maltreatment ◽  
Emotional Abuse ◽  
Suicide Attempts ◽  
Meta Analysis ◽  
Current Evidence ◽  
Bibliographic Databases ◽  
Increased Risk ◽  
Different Types

AbstractThis comprehensive systematic review and meta-analysis aims to quantify the association between different types of childhood maltreatment and suicidality. We searched five bibliographic databases, including Medline, PsychINFO, Embase, Web of Science and CINAHL, until January 2018. Random-effects meta-analysis was employed followed by univariable and multivariable meta-regressions. Heterogeneity was quantified using theI2statistic and formal publication bias tests were undertaken. The methodological quality of the studies was critically appraised and accounted in the meta-regression analyses. Data from 68 studies based onn= 261.660 adults were pooled. All different types of childhood maltreatment including sexual abuse [odds ratio (OR) 3.17, 95% confidence interval (CI) 2.76–3.64], physical abuse (OR 2.52, 95% CI 2.09–3.04) and emotional abuse (OR 2.49, 95% CI 1.64–3.77) were associated with two- to three-fold increased risk for suicide attempts. Similar results were found for the association between childhood maltreatment and suicidal ideation. Complex childhood abuse was associated with a particularly high risk for suicide attempts in adults (OR 5.18, 95% CI 2.52–10.63). Variations across the studies in terms of demographic and clinical characteristics of the participants and other core methodological factors did not affect the findings of the main analyses. We conclude that there is solid evidence that childhood maltreatment is associated with increased odds for suicidality in adults. The main outstanding challenge is to better understand the mechanisms which underpin the development of suicidality in people exposed to childhood maltreatment because current evidence is scarce.

scholarly journals 5-HTTLPR polymorphism in the serotonin transporter gene and migraine: A systematic review and meta-analysis

Cephalalgia ◽  
2010 ◽  
Vol 30 (11) ◽  
pp. 1296-1305 ◽  
Author(s):  
Markus Schürks ◽  
Pamela M Rist ◽  
Tobias Kurth
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Recessive Model ◽  
Dominant Model ◽  
Migraine Aura ◽  
Transporter Gene ◽  
Increased Risk ◽  
Genotype Information ◽  
S Allele ◽  
European Women

Background and methods: Data on the association between the SLC6A4 5-HTTLPR polymorphism and migraine are conflicting. We performed a systematic review and meta-analysis among studies published up to September 2009. For each study with genotype information, we calculated odds ratios (OR) and 95% confidence intervals (CI) assuming additive, dominant, and recessive genetic models. We then calculated pooled ORs and 95% CIs. Results: Among the ten studies identified there was no overall association between the polymorphism and any migraine for Europeans or Asians. However, European women carrying the S allele had an increased risk for any migraine (dominant model: pooled OR = 2.02; 95% CI 1.24–3.28). Results among Europeans further suggested an increased risk for migraine with aura among carriers of the S/S genotype (recessive model: pooled OR = 1.41; 95% CI 0.83–2.40). Conclusions: While our results indicate no overall association between the SLC6A4 5-HTTLPR polymorphism and migraine among Europeans and Asians, gender and migraine aura status may have modifying roles among Europeans.

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