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Anemia in young patients with ischaemic stroke
ConclusionAnemia on admission was associated with stroke in CeAD patients and with more severe strokes in both study samples. Moderate to severe anemia may predict unfavorable outcome.
Source: European Journal of Neurology - February 24, 2015 Category: Neurology Authors: L. Kellert, M. Kloss, A. Pezzini, T. M. Metso, A. J. Metso, S. Debette, D. Leys, V. Caso, V. Thijs, A. Bersano, E. Touzé, T. Tatlisumak, H. Gensicke, P. A. Lyrer, J. Bösel, S. T. Engelter, C. Grond‐Ginsbach, Tags: Original Article Source Type: research

Response to Cassidy and Cote
We thank Drs Cassidy and Cote for their letter in response to our article “Case Misclassification….” It appears as if the methods and impact of our study was misinterpreted and we appreciate the opportunity to offer clarification. Our primary aim was very simple—to determine the positive predictive value (PPV) for identifying cervical artery dissection (CAD) by using the search strategy used in the studies by Rothwell and Cassidy. The earlier studies purport to negate the causal association between cervical manipulative therapy (CMT) and CAD by demonstrating a similar association between visits to primary care phys...
Source: Journal of Stroke and Cerebrovascular Diseases - February 24, 2015 Category: Neurology Authors: David E. Thaler Tags: Letter to the Editor Source Type: research

Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial
Publication date: Available online 12 February 2015 Source:The Lancet Neurology Background Extracranial carotid and vertebral artery dissection is an important cause of stroke, especially in young people. In some observational studies it has been associated with a high risk of recurrent stroke. Both antiplatelet drugs and anticoagulant drugs are used to reduce risk of stroke but whether one treatment strategy is more effective than the other is unknown. We compared their efficacy in the Cervical Artery Dissection in Stroke Study (CADISS), with the additional aim of establishing the true risk of recurrent stroke. Methods W...
Source: The Lancet Neurology - February 13, 2015 Category: Neurology Source Type: research

Articles Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial
We found no difference in efficacy of antiplatelet and anticoagulant drugs at preventing stroke and death in patients with symptomatic carotid and vertebral artery dissection but stroke was rare in both groups, and much rarer than reported in some observational studies. Diagnosis of dissection was not confirmed after review in many cases, suggesting that radiographic criteria are not always correctly applied in routine clinical practice.
Source: Lancet Neurology - February 12, 2015 Category: Neurology Authors: The CADISS trial investigators Tags: Articles Source Type: research

Cervical Artery Dissection in Young Adults in the Stroke in Young Fabry Patients (sifap1) Study
Background: Patients with carotid artery dissection (CAD) have been reported to have different vascular risk factor profiles and clinical outcomes to those with vertebral artery dissection (VAD). However, there are limited data from recent, large international studies comparing risk factors and clinical features in patients with cervical artery dissection (CeAD) with other TIA or ischemic stroke (IS) patients of similar age and sex. Methods: We analysed demographic, clinical and risk factor profiles in TIA and IS patients ≤55 years of age with and without CeAD in the large European, multi-centre, Stroke In young FAbry Pa...
Source: Cerebrovascular Diseases - January 23, 2015 Category: Neurology Source Type: research

Self-Expanding Stent Placement for Anterior Circulation Intracranial Artery Dissection Presenting With Ischemic Symptoms
BACKGROUND: The prognosis of ischemic anterior circulation intracranial dissection (AC-ICD) is poor and its optimal management is still controversial. OBJECTIVE: To evaluate the safety and efficacy of a self-expanding stent for ischemic AC-ICD. METHODS: Eight patients (mean age, 36 years) underwent self-expanding stenting for ischemic AC-ICD. Imaging findings of ischemic AC-ICD, the reason for stenting, and the clinical and angiographic outcomes were retrospectively evaluated. RESULTS: AC-ICD involved intracranial internal carotid artery to middle cerebral artery (MCA) in 2, intracranial internal carotid artery alone in 3,...
Source: Neurosurgery - January 20, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

Risk of recurrent cervical artery dissection during pregnancy, childbirth and puerperium
ConclusionsOur observation suggests that the risk of recurrent CAD may not be greatly increased with pregnancies starting at least 12 months after CAD in women without typical connective tissue disease.
Source: European Journal of Neurology - November 29, 2014 Category: Neurology Authors: M. Reinhard, M. Munz, A.‐L. Kannen, H.‐J. Griesser‐Leute, R. Dittrich, S. T. Engelter Tags: Short Communication Source Type: research

Common variation in PHACTR1 is associated with susceptibility to cervical artery dissection
Nature Genetics 47, 78 (2015). doi:10.1038/ng.3154 Authors: Stéphanie Debette, Yoichiro Kamatani, Tiina M Metso, Manja Kloss, Ganesh Chauhan, Stefan T Engelter, Alessandro Pezzini, Vincent Thijs, Hugh S Markus, Martin Dichgans, Christiane Wolf, Ralf Dittrich, Emmanuel Touzé, Andrew M Southerland, Yves Samson, Shérine Abboud, Yannick Béjot, Valeria Caso, Anna Bersano, Andreas Gschwendtner, Maria Sessa, John Cole, Chantal Lamy, Elisabeth Medeiros, Simone Beretta, Leo H Bonati, Armin J Grau, Patrik Michel, Jennifer J Majersik, Pankaj Sharma, Ludmila Kalashnikova, Maria Nazarova, Larisa Dobrynina, E...
Source: Nature Genetics - November 24, 2014 Category: Genetics & Stem Cells Authors: Stéphanie DebetteYoichiro KamataniTiina M MetsoManja KlossGanesh ChauhanStefan T EngelterAlessandro PezziniVincent ThijsHugh S MarkusMartin DichgansChristiane WolfRalf DittrichEmmanuel TouzéAndrew M SoutherlandYves SamsonShérine AbboudYannick BéjotVal Tags: Letter Source Type: research

Connective tissue anomalies in patients with spontaneous cervical artery dissection
Conclusions: Connective tissue abnormalities are frequent in patients with sCeAD. This reinforces the hypothesis that systemic aberrations of the connective tissue might be implicated in the pathogenesis of the disease.
Source: Neurology - November 24, 2014 Category: Neurology Authors: Giossi, A., Ritelli, M., Costa, P., Morotti, A., Poli, L., Del Zotto, E., Volonghi, I., Chiarelli, N., Gamba, M., Bovi, P., Tomelleri, G., Carletti, M., Checcarelli, N., Meneghetti, G., Morra, M., Chinaglia, M., De Giuli, V., Colombi, M., Padovani, A., Pe Tags: Stroke in young adults, Carotid artery dissection, Risk factors in epidemiology ARTICLE Source Type: research

Combined thrombolysis in posterior circulation stroke caused by bilateral vertebral artery dissection in squash player.
CONCLUSIONS: Vertebral artery dissection should be taken into consideration in differential diagnosis of posterior circulation stroke or TIA in young patients with a history of even as subtle precipitating events as forceful head movements. Combined thrombolytic therapy may provide safe and effective treatment of stroke-complicated cases. This case report shows that expanded diagnostic protocol for acute ischemic stroke, including computed tomography perfusion study and angiography of cervical and cranial vessels, assures rapid and correct diagnosis. PMID: 25168332 [PubMed - indexed for MEDLINE]
Source: Neurologia i Neurochirurgia Polska - October 26, 2014 Category: Neurology Authors: Frankowska E, Brzozowski K, Staszewski J, Kolmaga N, Stępień A, Bogusławska-Walecka R Tags: Neurol Neurochir Pol Source Type: research

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Scientific Statement
Conclusions— CD is an important cause of ischemic stroke in young and middle-aged patients. CD is most prevalent in the upper cervical spine and can involve the internal carotid artery or vertebral artery. Although current biomechanical evidence is insufficient to establish the claim that CMT causes CD, clinical reports suggest that mechanical forces play a role in a considerable number of CDs and most population controlled studies have found an association between CMT and VAD stroke in young patients. Although the incidence of CMT-associated CD in patients who have previously received CMT is not well established, an...
Source: Stroke - September 22, 2014 Category: Neurology Authors: Biller, J., Sacco, R. L., Albuquerque, F. C., Demaerschalk, B. M., Fayad, P., Long, P. H., Noorollah, L. D., Panagos, P. D., Schievink, W. I., Schwartz, N. E., Shuaib, A., Thaler, D. E., Tirschwell, D. L., on behalf of the American Heart Association Strok Tags: AHA Statements and Guidelines AHA/ASA Scientific Statement Source Type: research

Case Misclassification in Studies of Spinal Manipulation and Arterial Dissection
Background: Spinal manipulation has been associated with cervical arterial dissection and stroke but a causal relationship has been questioned by population-based studies. Earlier studies identified cases using International Classification of Diseases Ninth Revision (ICD-9) codes specific to anatomic stroke location rather than stroke etiology. We hypothesize that case misclassification occurred in these previous studies and an underestimation of the strength of the association. We also predicted that case misclassification would differ by patient age.Methods: We identified cases in the Veterans Health Administration datab...
Source: Journal of Stroke and Cerebrovascular Diseases - September 1, 2014 Category: Neurology Authors: Xuemei Cai, Ali Razmara, Jessica K. Paulus, Karen Switkowski, Pari J. Fariborz, Sergey D. Goryachev, Leonard D'Avolio, Edward Feldmann, David E. Thaler Tags: Original Articles Source Type: research

E-007 Unusual Two Cases of Dissecting Cervical Internal Carotid Artery Pseudo-aneurysm with Symptomatic Intracranial Aneurysm
Conclusions In the evaluation of suspected intracranial aneurysm who present with headache with neck pain, a catheter cerebral angiogram not only will clearly define the correct morphology of intracranial aneurysm but also will appropriately identify the presence of life threatening cervical ICA abnormalities. Additionally, presence of an unusual cervical ICA anatomy with DP may warrant further evaluation of intracranial blood vessel of same territory. Using endovascular strategies, both extracranial and intracranial DP could be treated. However, long-term follow-up and outcome is unknown. Further studies are required. Di...
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Lodi, Y., Reddy, V., Devasenapathy, A., Chou, J., Shehades, K., Sethi, K., Galyon, D., Bajwa, S. Tags: Electronic poster abstracts Source Type: research

E-009 Dissecting Ruptured and Symptomatic Intracranial Pseudo-aneurysm who Underwent Endovascular Repair-A Case Series
Conclusions Our series demonstrates that dissecting intracranial aneurysm is predominantly present in the Petro-Cavernous junction of the ICA. Most of them could be treated successfully with good clinical outcome using stent-assisted coiling, stent-remodeling or primary coiling. However, the recurrence rate is extremely common; therefore close early follow-up is necessary for all cases especially those located in Petro-cavernous junction of the ICA. Further long-term follow-up study is required. Disclosures Y. Lodi: None. V. Reddy: None. A. Devasenapathy: None. J. Chou: None. K. Shehades: None. K. Sethi: None. D. Galyon: ...
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Lodi, Y., Reddy, V., Devasenapathy, A., Chou, J., Shehades, K., Sethi, K., Galyon, D., Bajwa, S. Tags: Electronic poster abstracts Source Type: research

Safety of Unilateral Endovascular Occlusion of the Cervical Segment of the Vertebral Artery without Antecedent Balloon Test Occlusion EDITOR'S CHOICE
CONCLUSIONS: In this series, endovascular occlusion of a cervical segment of 1 vertebral artery was safely performed without antecedent balloon test occlusion. As long as both vertebral arteries were patent and converged at the vertebrobasilar junction, there was anatomic potential for retrograde filling of the distal intracranial vertebral artery to the level of the posterior inferior cerebellar artery origin, and there was no major vascular supply to the spinal cord arising from the target segment of the affected vessel. Dominant and nondominant vertebral arteries were safely occluded, and no infarcts were attributed to the treatment.
Source: American Journal of Neuroradiology - May 15, 2014 Category: Radiology Authors: Zoarski, G. H., Seth, R. Tags: EDITOR ' S CHOICE Source Type: research

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