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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

Is This Primary Exertional Headache?
Discussion Commonly occurring primary headaches include tension, cluster and migraine headaches. “Other primary headaches” are often situational. Patients can have more than 1 type of these “other” headaches along with more common headaches. Other primary headaches as a group tend to be self-limited with long remission periods. Some other primary headaches include: Thunderclap headache Explosive sudden onset with maximum intensity in less 1 minute and resolution within 5 minutes usually 43/100,000 persons in adults Primary or secondary Secondary causes include intracranial hemorrhage, stroke, thro...
Source: PediatricEducation.org - November 21, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Massive Brainstem and Cerebellum Infarction Due to Traumatic Extracranial Vertebral Artery Dissection in a Motor Traffic Accident: An Autopsy Case Report
Traumatic unilateral vertebral artery (VA) injury can cause focal thrombosis and may block the basilar artery which can further lead to ischemic stroke and massive cerebral infarction and subarachnoid hemorrhage and even rapid death. Here, we present an autopsy case with a traumatic extracranial VA dissection in a motor traffic accident, and the identification of cause of death underwent 2 autopsies. A 62-year-old male pedestrian collided with the right rearview mirror of a car and fell down to the ground. He complained pains in the head and neck. Head computed tomography (CT) showed a right linear temporal bone fracture a...
Source: The American Journal of Forensic Medicine and Pathology - May 20, 2021 Category: Forensic Medicine Tags: Case Reports 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

Review on the Diagnosis and Treatment of Reversible Cerebral Vasoconstriction Syndrome in Children and Adolescents
Semin Neurol DOI: 10.1055/s-0040-1702942Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical–radiologic diagnosis that affects children and adolescents, but it is much more frequently reported in adults. Clinically, patients present with severe and commonly recurrent thunderclap headaches. Typical precipitating triggers include vasoactive substances, serotonergic agents, and the postpartum period. There may be associated neurologic complications at presentation or in the weeks following, such as convexity subarachnoid hemorrhage, stroke, cerebral edema, cervical artery dissection (CeAD), and seizures. Angio...
Source: Seminars in Neurology - February 19, 2020 Category: Neurology Authors: Qubty, William Irwin, Samantha Lee Fox, Christine K. Tags: Review Article Source Type: research

Imaging of Carotid Dissection
AbstractPurpose of ReviewHere, we describe the four primary imaging modalities for identification of carotid artery dissection, advantages, limitations, and clinical considerations. In addition, imaging characteristics of carotid dissection associated with each modality will be described.Recent FindingsRecent advances in etiopathogenesis describe the genetic factors implicated in cervical artery dissection. MRI/MRA (magnetic resonance angiography) with fat suppression is regarded as the best initial screening test to detect dissection. Advances in magnetic resonance imaging for the diagnosis of dissection include the use o...
Source: Current Pain and Headache Reports - January 19, 2019 Category: Neurology 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

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

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

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

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

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

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

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

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