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Advances in Management of the Stroke Etiology One-Percenters
AbstractPurpose of ReviewUncommon causes of stroke merit specific attention; when clinicians have less common etiologies of stoke in mind, the diagnosis may come more easily. This is key, as optimal management will in many cases differs significantly from “standard” care.Recent FindingsRandomized controlled trials (RCT) on the best medical therapy in the treatment of cervical artery dissection (CeAD) have demonstrated low rates of ischemia with both antiplatelet and vitamin K antagonism. RCT evidence supports the use of anticoagulation with vitamin K antagonism in “high-risk” patients with antiphospholipid antibody...
Source: Current Neurology and Neuroscience Reports - May 29, 2023 Category: Neuroscience 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

“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

Case Report: COVID-19 Infection and Cervical Artery Dissection
Am J Trop Med Hyg. 2022 Jan 24:tpmd210999. doi: 10.4269/ajtmh.21-0999. Online ahead of print.ABSTRACTA 45-year-old woman presented 3 days after symptom resolution from a COVID-19 infection with a left vertebral artery dissection with no known preceding trauma or underlying disposition. She subsequently suffered a left lateral medullary stroke 15 hours after her initial presentation. Cervical artery dissections (CeAD) can occur in the absence of trauma, and in some cases, infection may be a contributing factor. COVID-19 infection can cause an endotheliopathy and inflammatory response, which may contribute to intimal vessel ...
Source: Am J Trop Med Hyg - January 24, 2022 Category: Infectious Diseases Authors: Kaylynn Purdy Rebecca Long Glen Jickling Source Type: research