Antiplatelet Therapy vs Anticoagulation in Cervical Artery Dissection

This randomized clinical trial examines whether antiplatelent or anticoagulant therapy is more effective in preventing stroke in cervical dissection and the risk of recurrent stroke in a randomized clinical trial setting.
Source: JAMA Neurology - Category: Neurology Source Type: research

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We describe the case of a 39-year-old male, who presented to our emergency department after a one-day history of headache and vomiting, with associated sudden onset posterior neck pain and cerebellar signs following a massage. Computed tomography angiogram and brain demonstrated bilateral vertebral artery dissection and cerebellar stroke. He was admitted to hospital for monitoring and conservative management with antiplatelet therapy, resulting in a good outcome. This is the first reported case of bilateral vertebral artery dissection and stroke to be associated with massage. This case also suggests, unlike many reports in...
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
ConclusionsCurrent 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.
Source: Neuroradiology - Category: Radiology Source Type: research
Semin Neurol DOI: 10.1055/s-0040-1702942Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical–radiologic diagnosis that affects children and adolescents, but it is much more frequently reported in adults. Clinically, patients present with severe and commonly recurrent thunderclap headaches. Typical precipitating triggers include vasoactive substances, serotonergic agents, and the postpartum period. There may be associated neurologic complications at presentation or in the weeks following, such as convexity subarachnoid hemorrhage, stroke, cerebral edema, cervical artery dissection (CeAD), and seizures. A...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
CONCLUSIONS: In our cohort, a standard DWI sequence performed on the brain at the acute phase of a stroke or for a clinical suspicion of dissection detected nearly 90% of cervical ICA dissections.
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: EXTRACRANIAL VASCULAR Source Type: research
Salil Gupta, V Sharath KumarAnnals of Indian Academy of Neurology 2020 23(1):129-130
Source: Annals of Indian Academy of Neurology - Category: Neurology Authors: Source Type: research
Publication date: Available online 11 January 2020Source: Journal of Clinical NeuroscienceAuthor(s): Ching-Jen Chen, Ilana E. Green, Bradford B. Worrall, Andrew M. SoutherlandAbstractTo investigate potential association between collateral arterial supply and stroke in patients with isolated internal carotid artery dissection (iCeAD). We hypothesized a lower risk of stroke in patients with more robust collateral supply. This is a single-center, retrospective review of iCeAD patients between 1994 and 2018. iCeAD patients with sufficient neuroimaging data were included. Patients were categorized based on cerebral infarction (...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Herein, we described 2 patients with posterior spinal artery syndrome (PSAS) caused by vertebral artery dissection. The patients complained of sudden neck pain or walking instability. Neurological examination revealed sensory loss, muscle weakness, and sensory ataxia. Angiography showed double lumen sign or intimal flap in the vertebral artery. T2-weighted imaging and diffusion-weighted imaging of MRI showed a hyperintense lesion in the dorsal side of the cervical spinal cord at different times after onset.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
CONCLUSIONS: In our large series, the addition of a routine contrast-enhanced neck MRA to our pediatric stroke MR imaging protocol was of extremely low yield. We believe the use of neck MRA should reasonably be limited to cases in which abnormalities are initially detected on standard brain sequences or to patients with atypical presentation or recurrent pathology.
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: PEDIATRICS Source Type: research
Publication date: Available online 10 December 2019Source: Journal of Clinical NeuroscienceAuthor(s): David I. Bass, Melanie Walker, Louis J. Kim, Michael R. LevittAbstractIatrogenic dissection of the internal carotid artery is a well-known complication that can occur during mechanical thrombectomy for acute stroke. The vast majority of these injuries are limited to the cervical segment, and only in exceptional circumstances do they require surgical intervention. In the present case, extension of the lesion into the petrous segment of the carotid artery resulted in an acute neurologic decline necessitating emergent endovas...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
A randomized, prospective study from the United Kingdom and Australia was conducted between February 24, 2006 and June 17, 2013.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: There is no difference in treatment of carotid or vertebral artery dissection with antiplatelet vs anticoagulant therapy Source Type: research
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