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E-055 Internal carotid artery reconstruction with flow diverting stents in the treatment of acute ischemic stroke: technical considerations and medical management
ConclusionsFDS appear to be a safe and effective tool for reconstruction of a symptomatic dissection in tortuous cervical ICAs. Their flexibility allows conformation to complex anatomies and they can be traversed multiple times by aspiration catheters/stentrievers. We found excellent patency at follow up. The unique challenges posed by utilization of high-profile stents in acute stroke require appropriate technical execution and medical management.Disclosures E. Orru: None. F. Bounni: None. M. Marosfoi: None. N. Patel: None. A. Wakhloo: 1; C; Philips medical. 2; C; Stryker, Phenox. 4; C; InNeuroCo, EpiEP, Neural Analytics, ThrombX.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Orru, E., Bounni, F., Marosfoi, M., Patel, N., Wakhloo, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Vertebral Artery Dissection in a Woman Due to Golf: An Under Recognized Etiology
Conclusion: This patient is the first woman in the literature to suffer from VAD as a result of playing golf. The twisting motion of the head and neck in a golf swing may be a risk factor for dissection and subsequent development of stroke. As a result of increased female participation in golf, we expect to see increased incidence of women presenting with “golfer’s stroke” in coming years.
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Active Reperfusion Hemorrhage during Thrombectomy: Angiographic Findings and Real-Time Correlation with the CT “Spot Sign”
Conclusions: Active reperfusion hemorrhage involving perforator arteries was observed to correlate with the CT “spot sign” and to be associated with poor outcomes.Intervent Neurol 2018;7:370 –377
Source: Interventional Neurology - June 8, 2018 Category: Neurology Source Type: research

Dissection of Cervical and Cerebral Arteries
AbstractPurpose of ReviewWe aimed to summarize recent findings in cervical (CeAD) and intracranial artery dissection (IAD) research.Recent FindingsConsidered a disease of the young- and middle-aged, an analysis on the largest CeAD-population to date (n = 2391) revealed that about 1 of 14 CeAD-patients was aged ≥60 years. Distinct genetic variants were associated with CeAD. However, in clinical practice, genetic investigations are not helpful due to the small effect size. Despite the paucity of data from randomized-controlled trials in CeAD-s troke patients, both intravenous thrombolysis and endovascular treatment shou...
Source: Current Neurology and Neuroscience Reports - June 30, 2017 Category: Neuroscience Source Type: research

When a Single Antiplatelet Agent for Stroke Prevention Is Not Enough: Current Evidence and Future Applications of Dual Antiplatelet Therapy.
Abstract OPINION STATEMENT: For secondary stroke prevention, long-term dual antiplatelet therapy is not recommended due to increased bleeding risks. There is no specific evidence for using dual antiplatelet therapy for cervical artery dissection or for adding a second antiplatelet agent after a stroke while taking aspirin monotherapy. For patients with atrial fibrillation and stroke/TIA unable to tolerate warfarin, aspirin monotherapy is reasonable. Dual antiplatelet therapy carries a similar risk of major bleeding as warfarin that offsets reductions in stroke risk. Dual antiplatelet therapy is recommended for end...
Source: Atherosclerosis - February 27, 2016 Category: Cardiology Authors: Yuan K, Kim AS Tags: Curr Treat Options Cardiovasc Med Source Type: research

When a Single Antiplatelet Agent for Stroke Prevention Is Not Enough: Current Evidence and Future Applications of Dual Antiplatelet Therapy
Opinion statement For secondary stroke prevention, long-term dual antiplatelet therapy is not recommended due to increased bleeding risks. There is no specific evidence for using dual antiplatelet therapy for cervical artery dissection or for adding a second antiplatelet agent after a stroke while taking aspirin monotherapy. For patients with atrial fibrillation and stroke/TIA unable to tolerate warfarin, aspirin monotherapy is reasonable. Dual antiplatelet therapy carries a similar risk of major b...
Source: Current Treatment Options in Cardiovascular Medicine - February 24, 2016 Category: Cardiology Source Type: research

Cervical Artery Dissections in the Vancouver General Hospital (VGH) Stroke Database: A common stroke mechanism? (P5.161)
Conclusion: In this preliminary review, we have identified 26 patients with CAD in the first 6 months of our database collection. Although these results are from a single centre, this incidence of cervical artery dissection is much higher than expected. This analysis is ongoing and we will assess race-ethnicity, presenting features and preceding history of trauma and infection.Disclosure: Dr. Wilson has nothing to disclose. Dr. Salmeen has nothing to disclose. Dr. Field has received personal compensation in an editorial capacity for Postgraduate Medicine. Dr. Yip has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Wilson, L., Salmeen, A., Field, T., Yip, S. Tags: Cerebrovascular Disease and Interventional Neurology: Dissection Source Type: research

Comment CADISS: a feasibility trial that answered its question
Anticoagulation after ischaemic stroke was a topic of major controversy for decades until a series of randomised clinical trials consistently showed no net benefit of heparin or warfarin compared with aspirin.1,2 Any reduction in the risk of recurrent ischaemic stroke was offset by an increase in risk of intracerebral haemorrhages. One cause of stroke for which the effect of anticoagulation remains unclear is cervical artery dissection. The classic dogma was that a tear in the intima leads to formation of a fibrin-rich thrombus and poses a very high risk of artery-to-artery embolism or occlusion, making early anticoagulati...
Source: Lancet Neurology - February 12, 2015 Category: Neurology Authors: Scott E Kasner Tags: Comment Source Type: research

Imaging of cervical artery dissection
Publication date: Available online 20 November 2014 Source:Diagnostic and Interventional Imaging Author(s): W.B. Hassen , A. Machet , M. Edjlali-Goujon , L. Legrand , A. Ladoux , C. Mellerio , E. Bodiguel , M.-P. Gobin-Metteil , D. Trystram , C. Rodriguez-Regent , J.-L. Mas , M. Plat , C. Oppenheim , J.-F. Meder , O. Naggara Cervical artery dissection (CAD) may affect the internal carotid and/or the vertebral arteries. CAD is the leading cause of ischemic stroke in patients younger than 45 years. Specific treatment (aspirin or anticoagulants) can be implemented once the diagnosis of CAD has been confirmed. This diagnosis...
Source: Diagnostic and Interventional Imaging - November 21, 2014 Category: Radiology Source Type: research

Efficacy and Safety of Novel Oral Anticoagulants in Patients with Cervical Artery Dissections
We report on the use, safety, and efficacy of NOACs in the treatment of CAD. Methods: We retrospectively identified patients diagnosed with CAD at a single academic center between January 2010 and August 2013. Patients were categorized by their antithrombotic treatment at hospital discharge with a NOAC (dabigatran, rivaroxaban, or apixaban), traditional anticoagulant (AC: warfarin or treatment dose low-molecular weight heparin), or antiplatelet agent (AP: aspirin, clopidogrel, or aspirin/extended-release dypyridamole). Using appropriate tests, we compared the baseline medical history, presenting clinical symptoms and initi...
Source: Cerebrovascular Diseases - November 12, 2014 Category: Neurology Source Type: research

Stroke Due To Extracranial Internal Carotid Artery Dissection After Roller Coaster Rides In A 4-Year-Old Boy (P7.343)
CONCLUSIONS: To our knowledge this is the youngest patient with stroke secondary to ICA dissection following roller-coaster rides. Although the exact mechanism of injury leading to ICA dissection in the setting of sudden linear acceleration, deceleration and rotational forces such as those experienced while riding a roller coaster is not fully understood, these injuries have been attributed to brief sustained excessive gravitational forces likely augmented among predisposed individuals. Children may be at higher risk due to the immature anatomy of their cervical spine. Alterations to roller coaster ride dynamics and use of...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Nouh, A., Vela-Duarte, D., Grobelny, T., Hoganson, G., Pasquale, D., Biller, J. Tags: Child Neurology and Developmental Neurology VI Source Type: research