Cerebral collaterals and stroke in patients with isolated carotid artery dissections

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 (stroke) on neuroimaging. The collaterals score, ranging from 0 to 8 with higher scores indicating more robust collaterals, was assessed based on contributions from leptomeningeal arteries (0–2 points), anterior communicating artery (0–2 points) and anterior cerebral artery A1 segment (0–2 points), and posterior communicating artery (0–2 points). The study included 62 iCeAD patients, comprising 33 and 29 patients in the stroke and no stroke groups, respectively. Neurological motor deficit (p 4 had a sensitivity and specificity of 89.7% and 36.4% for no stroke, respectively. The covariate-adjusted AUROC curve was 0.514. Collateral circulation appeared to be a poor predictor of cerebral infarction in patients with isolated iCeAD. Future studies in larger, independent cohorts are needed to better understand the interaction of collate...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research

Related Links:

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
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
CONCLUSION: As the management paradigms of tandem occlusions continue to evolve, this technique may improve outcomes by expediting endovascular intervention. Using the stent retriever wire provides a method of expediting the management of the proximal lesion after addressing the more distal intracranial occlusion first. PMID: 31696768 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
We present the case of a spinal cord-injured patient with neurological sequelae and delayed posterior circu-la-tion stroke caused by bilateral vertebral artery dissection. The signs of cerebellar and occipital lobe ischemia were masked by manifestations of spinal cord injury. The patient was unconscious and in a serious condition, but, despite no proper stroke treatment, only residual dysarthria and upper limb ataxia were seen after reha-bilitation. Any clinical suspicion based on the combination of head or neck trauma with atypical or evolving neuro-logical symptoms should be verified for the possibility of a vertebral ar...
Source: Ortopedia, Traumatologia, Rehabilitacja - Category: Orthopaedics Authors: Tags: Ortop Traumatol Rehabil Source Type: research
Conclusion: The presence of atherosclerotic disease is considered rare in patients with cervical arterial dissection; however, our study found a high frequency of hypertension, smoking and dyslipidemia. The choice of antithrombotic remains controversial and will depend on the judgment of the medical professional; the clinical results with anticoagulation or antiaggregation were similar but there was more recanalization in the group treated with anticoagulation; its course was favorable in both situations. The recurrence of cervical arterial dissection and stroke is considered a rare event and its course is favorable.RESUMO...
Source: Arquivos de Neuro-Psiquiatria - Category: Neurology Source Type: research
In this issue of Journal of Neuro-Ophthalmology, M. Tariq Bhatti, MD and Mark L. Moster, MD will discuss the following 6 articles: Markus HS, Levi C, King A, Madigan J, Norris J; Cervical Artery Dissection in Stroke Study (CADISS) Investigators. Antiplatelet Therapy vs Anticoagulation Therapy in Cervical Artery Dissection: The Cervical Artery Dissection in Stroke Study (CADISS) Randomized Clinical Trial Final Results. JAMA Neurol. [published ahead of print February 25, 2019] doi: 10.1001/jamaneurol.2019.0072.Cortese I, Muranski P, Enose-Akahata Y, Ha SK, Smith B, Monaco M, Ryschkewitsch C, Major EO, Ohayon J, Schindler MK...
Source: Journal of Neuro-Ophthalmology - Category: Opthalmology Tags: Literature Commentary Source Type: research
Abstract As a whole, rare stroke causes represent a frequent stroke etiology. Since rare stroke causes affect primarily young patients, early diagnosis and treatment are of high socioeconomic relevance. In our everyday clinical practice, cervical artery dissection, which is the most common stroke etiology among patients
Source: Der Nervenarzt - Category: Neurology Authors: Tags: Nervenarzt Source Type: research
More News: Brain | Cervical Discectomy | Neurology | Neuroscience | Stroke | Study