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Causes of Horner Syndrome: A Study of 318 Patients
Conclusions: The prevalence of causes of Horner syndrome depends on the accrual method. Among pharmacologically-confirmed cases, the cause was often undetermined or due to a preceding neck or chest procedure. Among pharmacologically-unconfirmed cases, a substantial proportion had also been caused by neck and chest procedures, but tumors in that region were also common. When a cause of Horner syndrome was found in both cohorts, it was usually known before Horner syndrome was discovered, making Horner syndrome an afterthought. However, in an important minority of cases where the cause was not yet known, the identification ...
Source: Journal of Neuro-Ophthalmology - August 25, 2020 Category: Opthalmology Tags: Original Contribution Source Type: research

Effectiveness of statins in patients with stroke due to cervical artery dissection: A preliminary study.
This study aimed to investigate the effect of statins on neurological outcomes after a stroke due to CAD. METHODS: We conducted a prospective cohort study including consecutive patients diagnosed with a stroke due to CAD. Subjects were classified into non-statin, simvastatin 20mg, simvastatin 40mg, and high-potency statin groups. After 2 years, the functional outcome, stroke recurrence, major cardiovascular events, and mortality were assessed. RESULTS: Among the 54 patients included in our cohort, there were 16 (29.6%) patients without statins, 22 (40.7%) with simvastatin 20mg, 12 (22.2%) with simvastatin 40mg and ...
Source: Medicina Clinica - August 23, 2020 Category: General Medicine Tags: Med Clin (Barc) Source Type: research

Surgical Technique for Carotid Endarterectomy: Current Methods and Problems.
Authors: Uno M, Takai H, Yagi K, Matsubara S Abstract Over the last 60 years, many reports have investigated carotid endarterectomy (CEA) and techniques have thus changed and improved. In this paper, we review the recent literature regarding operational maneuvers for CEA and discuss future problems for CEA. Longitudinal skin incision is common, but the transverse incision has been reported to offer minimal invasiveness and better cosmetic effects for CEA. Most surgeons currently use microscopy for dissection of the artery and plaque. Although no monitoring technique during CEA has been proven superior, multiple mon...
Source: Neurologia Medico-Chirurgica - August 19, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Cervical Artery Dissection Caused by Electrical Cupping Therapy with High-Negative Pressure – Case Report
Cervical artery dissection is an important cause of stroke in the young. The etiology is still discussed controversial. The most obvious reason for a dissection of extracranial arteries is due to a trauma, eg. after car accidents or other high speed traumas such as high-velocity road traffic accidents. Besides these clear cases, chiropractic neck maneuvers represent potential reasons for vessel injuries. Case presentation: We here report a rare case of secondary cervical artery dissection after so-called cupping therapy and a preventive treatment with a direct oral anticoagulant.
Source: Journal of Stroke and Cerebrovascular Diseases - August 17, 2020 Category: Neurology Authors: Fr édéric Zuhorn, Wolf-Rüdiger Schäbitz, Christian Oelschläger, Randolf Klingebiel, Andreas Rogalewski Tags: Case Report Source Type: research

Cervical Artery Dissections with and without stroke, risk factors and prognosis: a Chilean prospective cohort
We aimed to characterize spontaneous cervical artery dissection (CeAD) patients with and without stroke and describe risk factors for cerebrovascular complications in a Chilean prospective cohort.Methods: Consecutive CeAD patients admitted to a Chilean center confirmed by neuroimaging. Logistic regression was used.Results: 168 patients were included, median follow-up time was 157 days. Stroke occurred in 49 (29.2%) cases, 4 (2%) patients died, all of whom had a stroke, and 10 (6%) presented CeAD recurrence.
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2020 Category: Neurology Authors: E. Mazzon, D. Rocha, A.M. Brunser, C. De la Barra, X. Stecher, T. Bernstein, P. Z úñiga, V. Díaz, G. Martínez, P. Muñoz Venturelli Source Type: research

Thyrotoxicosis and bilateral internal carotid artery dissections
Cervical artery dissection is a rare but important diagnosis to consider in young patients presenting with stroke. Multiple etiologies of cervical artery dissections have been previously reported, but the association with thyrotoxicosis is extremely rare. A previously healthy 43-year-old female presented to the emergency department with new symptoms related to thyrotoxicosis and bilateral internal carotid artery dissections. Her atrial fibrillation and hypertension resolved by treating the underlying hyperthyroidism with methimazole and propranolol.
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Thomas Winter, Eyal Kraut, Kristjan Thompson Tags: Case Report Source Type: research

A rare case of thyrotoxicosis and bilateral internal carotid artery dissections
Cervical artery dissection is a rare but important diagnosis to consider in young patients presenting with stroke. Multiple etiologies of cervical artery dissections have been previously reported, but the association with thyrotoxicosis is extremely rare. A previously healthy 43-year-old female presented to the emergency department with new symptoms related to thyrotoxicosis and bilateral internal carotid artery dissections. Her atrial fibrillation and hypertension resolved by treating the underlying hyperthyroidism with methimazole and propranolol.
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Thomas Winter, Eyal Kraut, Kristjan Thompson Source Type: research

“COVID-19 and cervical artery dissection- A causative association?”
COVID-19 is a pandemic disease which predominantly affects the respiratory system, however it also causes multi-organ dysfunction in a subset of patients. There is a growing evidence that it increases the propensity of strokes in younger patients. Besides producing a prothrombotic state, arterial dissection could be one of its many manifestations, increasing the risks of stroke. Herein, we report the first case of spontaneous bilateral vertebral artery dissection in a patient with COVID-19. 39-year female presented with spontaneous bilateral vertebral artery dissections without any instigating traumatic events and no histo...
Source: Journal of Stroke and Cerebrovascular Diseases - June 12, 2020 Category: Neurology Authors: Pratit Patel, Priyank Khandelwal, Gaurav Gupta, Amit Singla Source Type: research

Reversible Cerebral Vasoconstriction Syndrome and Dissection in the Setting of COVID-19 Infection
The current COVID-19 pandemic has recently brought to attention the myriad of neuro- logic sequelae associated with Coronavirus infection including the predilection for stroke, particularly in young patients. Reversible cerebral vasoconstriction syndrome (RCVS) is a well-described clinical syndrome leading to vasoconstriction in the intracra- nial vessels, and has been associated with convexity subarachnoid hemorrhage and oc- casionally cervical artery dissection. It is usually reported in the context of a trigger such as medications, recreational drugs, or the postpartum state; however, it has not been described in COVID-19 infection.
Source: Journal of Stroke and Cerebrovascular Diseases - June 4, 2020 Category: Neurology Authors: Katarina Dakay, Gurmeen Kaur, Edwin Gulko, Justin Santarelli, Christian Bowers, Stephan A Mayer, Chirag D Gandhi, Fawaz Al-Mufti Tags: Case Report Source Type: research

Serum-Based Proteomics Reveals Lipid Metabolic and Immunoregulatory Dysregulation in Cervical Artery Dissection With Stroke
In conclusion, proteomic analysis reveals that early perturbation of immunoregulation and lipid metabolism may be involved in the pathophysiology of CAD. Specifically, the panel of six proteins identified is promising as serum-based biomarkers for the detection of increased CAD risk in stroke subjects.
Source: Frontiers in Neurology - May 18, 2020 Category: Neurology Source Type: research

Surgical thromboendarterectomy for free-floating thrombus associated with cervical carotid artery dissection: A case report
Free-floating thrombus (FFT) of the cervical carotid artery is a rare but critical condition leading to stroke. The most common underlying pathology is atherosclerotic plaque; non-atherosclerotic pathologies are much rarer. Here we report a case of FFT associated with cervical carotid artery dissection that was successfully treated by surgical thromboendarterectomy.
Source: Annals of Vascular Surgery - May 17, 2020 Category: Surgery Authors: Taichiro Imahori, Kazuhiro Tanaka, Atsushi Arai, Eiji Kohmura Tags: Case Report Source Type: research

Long-term outcome of cervical artery dissection
AbstractLong-term consequences of cervical artery dissection (CeAD), a major cause of ischemic stroke in young people, have been poorly investigated. The Italian Project on Stroke at Young Age – Cervical Artery Dissection (IPSYS CeAD) project is a multicenter, hospital-based, consecutively recruiting, observational, cohort study aimed to address clinically important questions about long-term outcome of CeAD patients, which are not covered by other large-scale registries. Patients with r adiologically diagnosed CeAD were consecutively included in the registry. Baseline demographic and clinical variables, as well as inform...
Source: Neurological Sciences - May 11, 2020 Category: Neurology Source Type: research

Increased Risk of Stroke Among Young Adults With Serious Traumatic Brain Injury
Conclusions: These findings add to a growing body of work demonstrating that the acute and postacute stages of TBI play an accelerative role in AIS risk, particularly among younger patients, cervical artery dissection, and serious TBI.
Source: The Journal of Head Trauma Rehabilitation - May 1, 2020 Category: Neurology Tags: Focus on Clinical Research and Practice Source Type: research

Internal Carotid Artery Dissection Treated with C-Guard Stent
Int J Angiol DOI: 10.1055/s-0040-1708839Internal carotid dissection is the most common cause of stroke in the young population. Stroke, the presence of a pseudoaneurysm, and decreased artery lumen with cerebral flow impairment are indications for treatment. Medical therapy with antithrombotic drugs and endovascular therapy with stenting are the main available options. The C-Guard stent is an open cell mesh-covered dual layer stent that has been mainly used in cases of internal carotid artery stenosis with a post-operative reduction in stroke incidence. Thus, we present two cases of internal carotid artery dissections of th...
Source: International Journal of Angiology - April 27, 2020 Category: Cardiology Authors: Saal-Zapata, Giancarlo Durand, Walter Valer, Dante Rodr íguez, Rodolfo Tags: Case Report 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

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