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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

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

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

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

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

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

Concomitant cervical spine fractures are the primary driver of disability after traumatic vertebral artery dissection: A Case series of 123 patients
Conclusion: tVADs may be associated with stroke and/or cervical fracture. Presenting symptoms predict stroke, but baseline demographic and clinical characteristics do not. Comorbid cervical fractures, not stroke, drive negative outcomes
Source: Journal of Craniovertebral Junction and Spine - December 7, 2022 Category: Orthopaedics Authors: Michael Brendan Cloney Anastasios G Roumeliotis Hooman A Azad Nikil Prasad Nathan A Shlobin Benjamin S Hopkins Babak S Jahromi Matthew B Potts Nader S Dahdaleh Source Type: research

The Association Between Cervical Spine Manipulation and Carotid Artery Dissection: A Systematic Review of the Literature
Controversy surrounds the safety of cervical spine manipulation. Ischemic stroke secondary to cervical spine manipulation is a hypothesized adverse event. In Canada, the seriousness of these events and their perceived association to cervical spine manipulation has led some members of the public to call for a ban of the procedure. The primary objective of this study was to determine the incidence of internal carotid artery (ICA) dissection after cervical spine manipulation in patients who experience neck pain and its associated disorders.
Source: Journal of Manipulative and Physiological Therapeutics - January 6, 2014 Category: Complementary Medicine Authors: Chadwick L.R. Chung, Pierre Côté, Paula Stern, Georges L'Espérance Source Type: research

Ischemic Cervical Myelopathy Caused by Vertebral Artery Dissection: The Clinical Utility of a Motor-evoked Potential Study
Conclusions: When there is diagnostic ambiguity between the upper and lower motor neuron lesions in VAD, motor-evoked potential study can be helpful to diagnose peripheral neurological complication of VAD.
Source: The Neurologist - December 28, 2015 Category: Neurology Tags: Case Report/Case Series Source Type: research

The Bizarre Side Effect 1 In 100 People Experience During Sex
For SELF, by Zahra Barnes. As your sexual arousal ramps up on the trippy journey to orgasm, pleasure is probably the only thing on your mind. Unfortunately, for some people, pain interrupts the party. At least one percent of adults experience coital cephalalgia, or “sex headaches,” aka head pain that occurs before, during, or after orgasm. Here’s what you need to know about this condition, which is basically the unpleasant epitome of a buzzkill. Mayo Clinic spotlights two kinds of sex headaches. The first is “a dull ache in the head and neck that intensifies as sexual excitement increases,” a...
Source: Healthy Living - The Huffington Post - March 15, 2017 Category: Consumer Health News Source Type: news

Poster 328: Bilateral Vertebral Artery Dissection, Spinal Cord Infarct and Brainstem Stroke in a Patient with Posterior Neck Pain Before Cervical Manipulation: A Case Report
Sima Patel: I Have No Relevant Financial Relationships To Disclose
Source: PM and R - September 1, 2017 Category: Rehabilitation Authors: Sima C. Patel Source Type: research

Perioperative complications in patients treated with posterior cervical fusion and bilateral cages
Conclusions: The results of our study show that PCF with cages can be considered a safe alternative for patients undergoing cervical spine surgery. The procedure has a favorable overall complication profile, short length of stay, and negligible blood loss.
Source: Journal of Craniovertebral Junction and Spine - December 19, 2017 Category: Orthopaedics Authors: Krzysztof B Siemionow Pawel Glowka Robert J Blok Mark C Gillespy Mukund I Gundanna William D Smith Zeshan Hyder Bruce M McCormack Source Type: research

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