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E-108 Endovascular treatment of patients with acute ischemic stroke due to underlying arterial dissection: a nationwide analysis
ConclusionsDespite a similar prevalence among patients admitted for AIS, CA dissections are associated with a higher rate of endovascular intervention and poorer short-term outcomes compared to VA dissections. This study provides essential epidemiologic and outcome data for the cerebrovascular neurosurgeon.Abstract E-108 Table 1Comparison of clinical characteristics and outcomes among patients presenting with acute ischemic stroke due to carotid or vertebral artery dissections Characteristic Vertebral Artery Dissection, N = 2,562 Carotid Artery Dissection, N = 2,789 p-value1 Age (years), Mean (SD) 53 (17) 57 (17) <0.00...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Brandel, M., McCann, C., Wali, A., Wu, V., Esmail, S., Steinberg, J., Olson, S., Pannell, J., Khalessi, A., Santiago-Dieppa, D. Tags: SNIS 20th annual meeting electronic poster abstracts 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

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

Differences and Similarities Between Spontaneous Dissections of the Internal Carotid Artery and the Vertebral Artery
There are clinical, pathologic, and outcome differences in spontaneous dissections of the internal carotid artery vs those of the vertebral artery. Spontaneous cervical artery dissection is a major cause of stroke in younger patients. Spontaneous cervical artery dissection causes up to 25% of all ischemic strokes in patients 15 to 49 years of age (Putaala J et al, Stroke 2009;40:1195-203). Although constitutional and environmental factors are both thought to play a role in spontaneous cervical artery dissection, precise causes are poorly understood. Significant differences between spontaneous internal carotid artery disse...
Source: Journal of Vascular Surgery - December 27, 2013 Category: Surgery Authors: M. von Babo, G.M. De Marchis, H. Sarikaya Tags: Abstracts 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

Treatment of Cervical Artery Dissection: Antithrombotics, Thrombolysis, and Endovascular Therapy.
Abstract Cervical artery dissection (CAD) is an important cause of stroke for young patients, accounting for 5-22% of strokes in patients <45 years of age, which presents not only a great burden to the stroke victims but also a financial burden to the family and society. Because CAD can lead to different clinical lesions, including neuropathy, acute ischemic stroke, and subarachnoid hemorrhage, and is an arterial dissection with a self-healing tendency, the treatment options depend on the clinical manifestations. The main purpose of the treatment is to control CAD-induced neuronal damage and to restore blood fl...
Source: Biomed Res - June 14, 2017 Category: Research Authors: Peng J, Liu Z, Luo C, Chen L, Hou X, Xiao L, Zhou Z Tags: Biomed Res Int Source Type: research

The Case Files: Traumatic Carotid Dissection
By Hsiao, Jonie MD   A 30-year-old man who was right-hand dominant presented 10 days after sustaining left-sided face and head trauma from a fall from a skateboard at an unknown speed. He lost consciousness for several seconds, and initially developed a headache with nausea and vomiting. A non-contrast head CT performed at another hospital done two days after the incident was reportedly negative.   He now presents primarily with concerns about the appearance of his left eye. He has notable anisocoria and a droopy eyelid. His left pupil is notably smaller, 2 mm, compared with the right eye, 5 mm. Both are reactive. The re...
Source: The Case Files - June 4, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Migraine and the Risk of Carotid Artery Dissection
Stroke incidence is increasing among patients aged 40 to 60 years —faster than in older age cohorts. Preliminary evidence suggests that ischemic stroke—not hemorrhage or subarachnoid hemorrhage—accounts for the increase. Many speculate that increasing incidences of classic vascular risk factors among young patients contribute to the increased incidence of st roke. Certainly, we are all aware of the obesity epidemic and continued prevalence of smoking, leading to premature atherosclerosis. Furthermore, equally relevant causes of stroke in the young include migraine, drug abuse, cervical arterial dissections, patent fo...
Source: JAMA Neurology - March 6, 2017 Category: Neurology Source Type: research

Review Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection
Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with mass effect, mostly on the brainstem. Although intracranial artery dissection is less common than cervical artery dissection in adults of European ethnic origin, intracranial artery dissection is reportedly more common in children and in Asian populations.
Source: Lancet Neurology - May 11, 2015 Category: Neurology Authors: Stéphanie Debette, Annette Compter, Marc-Antoine Labeyrie, Maarten Uyttenboogaart, Tina M Metso, Jennifer J Majersik, Barbara Goeggel-Simonetti, Stefan T Engelter, Alessandro Pezzini, Philippe Bijlenga, Andrew M Southerland, Olivier Naggara, Yannick Béj Tags: Review Source Type: research

Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection
Publication date: June 2015 Source:The Lancet Neurology, Volume 14, Issue 6 Author(s): Stéphanie Debette , Annette Compter , Marc-Antoine Labeyrie , Maarten Uyttenboogaart , Tina M Metso , Jennifer J Majersik , Barbara Goeggel-Simonetti , Stefan T Engelter , Alessandro Pezzini , Philippe Bijlenga , Andrew M Southerland , Olivier Naggara , Yannick Béjot , John W Cole , Anne Ducros , Giacomo Giacalone , Sabrina Schilling , Peggy Reiner , Hakan Sarikaya , Janna C Welleweerd , L Jaap Kappelle , Gert Jan de Borst , Leo H Bonati , Simon Jung , Vincent Thijs , Juan J Martin , Tobias Brandt , Caspar Grond-Ginsbach , Manja Klos...
Source: The Lancet Neurology - May 11, 2015 Category: Neurology Source Type: research

Intracranial Cerebral Artery Dissection of Anterior Circulation as a Cause of Convexity Subarachnoid Hemorrhage
Conclusion: Our data suggest that cSAH caused by intracranial cerebral artery dissection is not rare. Further investigations are needed to elucidate the precise mechanism underlying cSAH in cerebral artery dissection.Cerebrovasc Dis 2015;40:45-51
Source: Cerebrovascular Diseases - June 16, 2015 Category: Neurology Source Type: research

Thunderclap headache: Diagnostic considerations and neuroimaging features
Thunderclap headache (TCH) is an acute and severe headache that has maximum intensity at onset; TCH can be primary or secondary. Primary TCH is diagnosed when no underlying cause is discovered; however, imaging is crucial in distinguishing secondary causes, which are wide-ranging. The radiologist should be aware of the list of potential diagnoses. Subarachnoid haemorrhage (SAH) is the most common cause of secondary TCH. Aneurysmal SAH accounts for the majority of cases, although other causes should also be considered and these include perimesencephalic haemorrhage, arteriovenous malformations, and dural arteriovenous fistu...
Source: Clinical Radiology - December 13, 2012 Category: Radiology Authors: A.M. Mortimer, M.D. Bradley, N.G. Stoodley, S.A. Renowden Tags: Reviews Source Type: research

Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients
Conclusion: The association of RCVS and CeAD was found in 12% of our patients with RCVS and 7% of our patients with CeAD. Underlying mechanisms are unknown. In practice, our results point to the need for a systematic study of both cervical and intracranial arteries in the 2 conditions.
Source: Neurology - August 26, 2013 Category: Neurology Authors: Mawet, J., Boukobza, M., Franc, J., Sarov, M., Arnold, M., Bousser, M.-G., Ducros, A. Tags: Secondary headache disorders, Stroke in young adults, Carotid artery dissection, Subarachnoid hemorrhage ARTICLE Source Type: research

Endovascular treatment of fusiform intracranial vertebral artery aneurysms using reconstructive techniques
Conclusions The use of reconstructive techniques in the endovascular treatment of unruptured fusiform intracranial vertebral artery aneurysms is feasible, safe, and effective in the mid term. In patients presenting with SAH, however, the safety and effectiveness of these techniques remain unclear.
Source: Journal of NeuroInterventional Surgery - September 5, 2014 Category: Neurosurgery Authors: Dabus, G., Lin, E., Linfante, I. Tags: Hemorrhagic stroke Source Type: research

Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological Examination, and Normal Non Contrast CT: A Meta-Analysis
Patients with acute severe headache, normal neurological examination, and a normal noncontrast head computed tomography (NCCT) may still have subarachnoid hemorrhage, cerebral venous thrombosis (CVT), cervical arterial dissection, or reversible cerebral vasoconstriction syndrome (RCVS). Computed tomography angiography (CTA) is used increasingly in the emergency department for evaluating this, but its added value remains controversial.
Source: Journal of Stroke and Cerebrovascular Diseases - December 22, 2017 Category: Neurology Authors: Imanda M.E. Alons, Ben F.J. Goudsmit, Korne Jellema, Marianne A.A. van Walderveen, Marieke J.H. Wermer, Ale Algra Source Type: research

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