Carotid Artery Dissection and Ischemic Stroke Following Cervical Chiropractic Manipulation: Two Case Reports

2021 ◽  
pp. 153857442110726
Author(s):  
Yimin Chen ◽  
Mohammad Mofatteh ◽  
Thanh N. Nguyen ◽  
Jack Wellington ◽  
Wenlong Wei ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Case Reports ◽  
Recombinant Tissue Plasminogen Activator ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Physical Force ◽  
Aged Patients ◽  
Chiropractic Manipulation ◽  
Raising Awareness

Objective Patients can be at risk of carotid artery dissection and ischemic stroke after cervical chiropractic manipulation. However, such risks are rarely reported and raising awareness can increase the safety of chiropractic manipulations. Case Report We present two middle-aged patients with carotid artery dissection leading to ischemic stroke after receiving chiropractic manipulation in Foshan, Guangdong Province, China. Both patients had new-onset pain in their necks after receiving chiropractic manipulations. Excess physical force during chiropractic manipulation may present a risk to patients. Patient was administered with recombinant tissue plasminogen activator after radiological diagnoses. They were prescribed 100 mg and clopidogrel 75 mg daily for 3 months as dual antiplatelet therapy. There were no complications over the follow-up period. Conclusion These cases suggest that dissection of the carotid artery can occur as the result of chiropractic manipulations. Patients should be diagnosed and treated early to achieve positive outcomes. The safety of chiropractic manipulations should be increased by raising awareness about the potential risks.

Symptomatic Carotid Stenosis: Stroke and Transient Ischemic Attack

2019 ◽  
Author(s):  
Kenneth R. Ziegler ◽  
Thomas C. Naslund
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Ct Scan ◽  
Hemorrhagic Stroke ◽  
Fibromuscular Dysplasia ◽  
The United States ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Ct Angiogram ◽  
Ischemic Attack

Nearly 800,000 strokes are reported in the United States annually, with an economic impact upward of $33 billion. Carotid artery disease, familiar to all vascular surgeons, accounts for just over one fifth of these strokes. However, these cases reflect an opportunity for the surgeon to intervene and mitigate the substantial burden of stroke. This review includes the epidemiology of stroke in the United States and the carotid artery and noncarotid etiologies of stroke, including atherosclerotic disease, fibromuscular dysplasia, carotid artery dissection, and cardioembolism. The clinical presentations of ischemic and hemorrhagic stroke and transient ischemia attacks are examined, as are the major findings expected in the patient history and physical examination. Strategies for further evaluation of the patient are discussed, including the use of sonographic imaging of the carotid artery and the relative advantages and disadvantages among the dominant modes of brain imaging. New updates to the review include interventional approaches toward the treatment of acute ischemic stroke, as well as the latest strategies regarding the timing of carotid endarterectomy after stroke and the utility of carotid artery stenting in these patients, with active areas of current research highlighted. Figures show a computed tomographic (CT) angiogram of fibromuscular dysplasia of an internal carotid artery, a CT angiogram of an internal carotid artery dissection showing a defect in the dissection, a CT scan demonstrating hemorrhagic conversion of cardioembolic stroke, a CT scan of acute thalamic hemorrhage, a CT scan of evolving ischemic stroke, a T2-weighted image demonstrating acute left frontal stroke and remote right frontal stroke, T1- and T2-weighted images of right parietal ischemic stroke, and M1 occlusion of a middle cerebral artery treated successfully with transcatheter thrombectomy. Tables list Society of Radiologists in Ultrasound and University of Washington criteria for duplex ultrasound diagnosis of carotid artery stenosis.   This review contains 8 figures, 8 tables, and 68 references. Keywords: Carotid stenosis, ischemic stroke, transient ischemic attack, endovascular therapy, thrombolysis, infarct, hemorrhagic stroke, atherosclerosis, embolism

Internal carotid artery dissection as a cause of severe ischemic stroke with lethal outcome

2015 ◽  
Vol 115 (12. Vyp. 2) ◽  
pp. 19 ◽  
Author(s):  
L. A. Kalashnikova ◽  
R. P. Chaykovskaya ◽  
L. A. Dobrynina ◽  
A. V. Sakharova ◽  
T. S. Gulevskaya ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Lethal Outcome

Delayed Diagnosis of Carotid Artery Dissection Complicates Ischemic Stroke Treatment

2013 ◽  
Vol 32 (5) ◽  
pp. 262-267
Author(s):  
Azeemuddin Ahmed ◽  
Achint Singh ◽  
Elizabeth C. Hassebroek ◽  
Kris Baerenwald
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Delayed Diagnosis ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Stroke Treatment

scholarly journals TCD-directed therapy for cervical internal carotid artery dissection : two case reports

Neurosonology ◽  
2010 ◽  
Vol 23 (1) ◽  
pp. 9-12
Author(s):  
Hirokazu SADAHIRO ◽  
Hideyuki ISHIHARA ◽  
Hiroshi YONEDA ◽  
Syoichi KATO ◽  
Hiroko YOSHINO ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Case Reports ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Cervical Internal Carotid Artery

scholarly journals Stent placement for intracranial internal carotid artery dissection presenting with ischemic stroke

2012 ◽  
Vol 6 (3) ◽  
pp. 164-174 ◽  
Author(s):  
Ryushi KONDO ◽  
Yasushi MATSUMOTO ◽  
Ichiro SUZUKI ◽  
Toshio KIKUCHI ◽  
Hiroaki SHIMIZU ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection

scholarly journals Two Cases of Intracranial Internal Carotid Artery Dissection Presenting with Ischemic Stroke

2017 ◽  
Vol 11 (5) ◽  
pp. 253-259
Author(s):  
Atsushi Shindo ◽  
Atsushi Matsumoto ◽  
Hajime Shishido ◽  
Masanobu Okauchi ◽  
Naoki Hayashi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection

scholarly journals Endovascular Treatment of Stroke Caused by Carotid Artery Dissection

2020 ◽  
Vol 10 (11) ◽  
pp. 800
Author(s):  
Grzegorz Meder ◽  
Milena Świtońska ◽  
Piotr Płeszka ◽  
Violetta Palacz-Duda ◽  
Dorota Dzianott-Pabijan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Endovascular Treatment ◽  
Small Proportion ◽  
Mechanical Thrombectomy ◽  
Carotid Artery Dissection ◽  
Large Vessel ◽  
Artery Dissection ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion

Ischemic stroke due to large vessel occlusion (LVO) is a devastating condition. Most LVOs are embolic in nature. Arterial dissection is responsible for only a small proportion of LVOs, is specific in nature and poses some challenges in treatment. We describe 3 cases where patients with stroke caused by carotid artery dissection were treated with mechanical thrombectomy and extensive stenting with good outcome. We believe that mechanical thrombectomy and stenting is a treatment of choice in these cases.

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