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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

Risk of Carotid Stroke after Chiropractic Care: A Population-Based Case-Crossover Study
Chiropractic manipulation is a popular treatment for neck pain and headache, but may increase the risk of cervical artery dissection and stroke. Patients with carotid artery dissection can present with neck pain and/or headache before experiencing a stroke. These are common symptoms seen by both chiropractors and primary care physicians (PCPs). We aimed to assess the risk of carotid artery stroke after chiropractic care by comparing association between chiropractic and PCP visits and subsequent stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - November 20, 2016 Category: Neurology Authors: J. David Cassidy, Eleanor Boyle, Pierre C ôté, Sheilah Hogg-Johnson, Susan J. Bondy, Scott Haldeman Source Type: research

Bilateral vertebral artery dissection complicated by posterior circulation stroke in a young man: A case report
Conclusion: VAD should be taken into consideration in differential diagnosis of posterior circulation stroke or transient ischemic attack in young patients. Intravenous thrombolytic therapy may be safe and effective for stroke-complicated cases. This case report demonstrates that expanded diagnostic protocol for acute ischemic stroke assures rapid and correct diagnosis.
Source: Medicine - October 29, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Aortic dissection diagnosed on stroke computed tomography protocol: a case report
ConclusionsWhen acute stroke is suspected due to neurological deficits, plain head CT is the first choice for imaging diagnosis. The addition of cervical CT angiography can reliably exclude stroke due to aortic dissection. CTP can identify ischemic penumbra, which cannot be diagnosed by plain head CT or diffusion-weighted magnetic resonance imaging. These combined stroke CT protocols helped us avoid missing an aortic dissection.
Source: Journal of Medical Case Reports - May 26, 2021 Category: General Medicine Source Type: research

Does case misclassification threaten the validity of studies investigating the relationship between neck manipulation and vertebral artery dissection stroke? No
ConclusionCurrent evidence does not support the notion that misclassification threatens the validity of recent case –control studies investigating the relationship between CMT and VAD. Hence, the recent re-analysis cannot refute the conclusion from previous studies that CMT is not a cause of VAD.
Source: Chiropractic and Manual Therapies - November 4, 2016 Category: Complementary Medicine Source Type: research

Cervical artery dissection: Trauma and other potential mechanical trigger events
Conclusion: PCT seems to be an important environmental determinant of CeAD, but was not an independent outcome predictor. Because of the characteristics of most PCTs, the term mechanical trigger event rather than trauma may be more appropriate.
Source: Neurology - May 20, 2013 Category: Neurology Authors: Engelter, S. T., Grond-Ginsbach, C., Metso, T. M., Metso, A. J., Kloss, M., Debette, S., Leys, D., Grau, A., Dallongeville, J., Bodenant, M., Samson, Y., Caso, V., Pezzini, A., Bonati, L. H., Thijs, V., Gensicke, H., Martin, J. J., Bersano, A., Touze, E., Tags: Stroke in young adults, Other trauma, Carotid artery dissection ARTICLE Source Type: research

Bilateral vertebral artery dissection and cerebellar stroke: a rare complication of massage.
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 - April 5, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Stroke in a Young Swimmer
Conclusions: Important differential diagnoses of cervicocephalic arterial dissection include other vascular or neurological causes of head and neck pain and/or local neurological syndromes and other causes of brain ischemia such as cardiac emboli, atherosclerosis, and vasculopathy of brain vessels. It is important that sports medicine practitioners pay attention to this less-diagnosed cause of stroke in young athletes.,Introduction: Arterial dissections are important causes of stroke in the young population. Dissection has been reported in association with some sports. It seems that this report is among the first ones of t...
Source: Asian Journal of Sports Medicine - June 19, 2015 Category: Sports Medicine Source Type: research

Cervical artery dissection in patients >=60 years: Often painless, few mechanical triggers
Conclusion: In our study population of patients diagnosed with CeAD, 1 in 14 was aged ≥60 years. In these patients, pain and mechanical triggers might be missing, rendering the diagnosis more challenging and increasing the risk of missed CeAD diagnosis in older patients.
Source: Neurology - April 3, 2017 Category: Neurology Authors: Traenka, C., Dougoud, D., Simonetti, B. G., Metso, T. M., Debette, S., Pezzini, A., Kloss, M., Grond-Ginsbach, C., Majersik, J. J., Worrall, B. B., Leys, D., Baumgartner, R., Caso, V., Bejot, Y., Compter, A., Reiner, P., Thijs, V., Southerland, A. M., Ber Tags: Stroke in young adults, All Cerebrovascular disease/Stroke, Carotid artery dissection ARTICLE Source Type: research

Unusual complication of vertebral arterial dissection
Discussion This patient had subacute onset of cervical cord infarction. The history and MRI findings were in keeping with cervical dissection. The vertebral artery is most vulnerable as it travels in the vertebral foramen and makes a curvature at C1–2 and dissection at this point usually causing cerebellar infarction and lateral medullary syndrome. A spinal cord infarct may occur if the extra–cranial vertebral artery is involved. Intracranial vertebral arterial dissection has a poor prognosis for neurological recovery but are usually not fatal. Extracranial VAD may cause spinal cord infarction but respiratory f...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Shanmugam, S., Pullicino, P., Strandvik, G. Tags: Brain stem / cerebellum, Neuroimaging, Neurological injury, Pain (neurology), Stroke, Trauma CNS / PNS, Ophthalmology, Trauma, Injury Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 Octob Source Type: research

Acute neurology in the emergency department
A 66-year-old woman presented with sudden onset tearing interscapular pain 1 h after gentle neck exercises. Over the next 3 h, she developed flaccid left arm and leg paralysis and a left Horner's syndrome. Her initial CT scan revealed no evidence of cerebral ischaemia or aortic/carotid dissection but did reveal what was thought to be a calcified arteriovenous malformation in the right frontal lobe. Thrombolysis for a presumed acute stroke was considered but not initiated. By 5 h, the patient had lost light touch sensation and proprioception of her left side, and additionally she developed grade 3/5 right-sid...
Source: Emergency Medicine Journal - December 22, 2013 Category: Emergency Medicine Authors: Mertes, S. C. Tags: Eye Diseases, Spinal cord injury, Pain (neurology), Spinal cord, Stroke, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Trauma Images in emergency medicine Source Type: research

Characteristics and Outcomes of Patients With Multiple Cervical Artery Dissection Clinical Sciences
Conclusions— In the largest published series of patients with CeAD, we highlighted significant differences between multiple and single artery involvement. Features suggestive of an underlying vasculopathy (fibromuscular dysplasia) and environmental triggers (recent infection, cervical manipulation, and a remote history of head or neck surgery) were preferentially associated with multiple CeAD.
Source: Stroke - December 23, 2013 Category: Neurology Authors: Bejot, Y., Aboa-Eboule, C., Debette, S., Pezzini, A., Tatlisumak, T., Engelter, S., Grond-Ginsbach, C., Touze, E., Sessa, M., Metso, T., Metso, A., Kloss, M., Caso, V., Dallongeville, J., Lyrer, P., Leys, D., Giroud, M., Pandolfo, M., Abboud, S., on behal Tags: Carotid and Vertebral A. Dissection Clinical Sciences Source Type: research

Clinical Presentation, Magnetic Resonance Angiography, Ultrasound Findings, and Stroke Patterns in Patients with Vertebral Artery Dissection
Background/Aims: Vertebral artery dissection (VAD) is an important cause of ischemic stroke. In this observational study, clinical data, magnetic resonance (MR) and ultrasound (US) imaging findings and ischemic patterns were analyzed.Methods: Forty-seven patients with a diagnosis of VAD underwent clinical examination, US, MR of the brain and neck and MR angiography (MRA) of the cervical arteries. Vascular abnormalities and ischemic brain lesions were noted. Data were evaluated separately and compared for spontaneous and traumatic VAD subgroups.Results: The most common overall clinical symptom was vertigo followed by neck p...
Source: European Neurology - October 31, 2016 Category: Neurology Source Type: research

Cervical artery dissection: A common cause of stroke in young adults
Cervical artery dissection is a common cause of stroke in young adults and can lead to significant disability. Clinicians should be able to recognize the clinical presentation and diagnose this condition to prevent cerebral ischemia and its complications. Consider cervical artery dissection in a young adult with new-onset, unilateral head pain with or without neck pain with antecedent neck trauma, with or without neurologic deficits or risk factors for dissection. Early diagnosis can lead to better outcomes but the overall prognosis is good for young adults with cervical artery dissection.
Source: Journal of the American Academy of Physician Assistants - January 27, 2022 Category: Primary Care Tags: Review Article Source Type: research

036 A rare subtype of a rare type of stroke - sulcal artery syndrome
A 78 year old man was woken from sleep by a sudden excruciating neck pain. The pain was accompa- nied by left arm and leg weakness and paraesthesia which progressed to maximum intensity over hours. His past medical history was significant for ischaemic heart disease and type 2 diabetes. On examination there was an incomplete Brown-Sequard syndrome localising to the left hemicord. MRI of the cervical spine showed intramedullary T2 hyperintensity and restricted diffusion in the left hemicord at C2-C3 level. CT angiogram of the vertebral arteries excluded dissection. We diagnosed acute spinal cord infarction due to a sulcal a...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Win, M., Hernandez, A. C., Fox, R., Harikrishnan, S., McWilliam, M. Tags: Live Poster, 13 May Poster Session 1 Source Type: research

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