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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

The B árány Society position on 'Cervical Dizziness'
J Vestib Res. 2022 Nov 15. doi: 10.3233/VES-220202. Online ahead of print.ABSTRACTThis paper describes the Bárány Society Classification OverSight Committee (COSC) position on Cervical Dizziness sometimes referred to as Cervical Vertigo. This involved an initial review by a group of experts across a broad range of fields, and then subsequent review by the Bárány Society COSC. Based upon the so far published literature, the Bárány Society COSC takes the view that the evidence supporting a mechanistic link between an illusory sensation of self-motion (spinning or otherwise) and neck pathology and/or symptoms of neck pa...
Source: Journal of Vestibular Research: Equilibrium and Orientation - November 21, 2022 Category: Neuroscience Authors: Barry M Seemungal Yuri Agrawal Alexander Bisdorff Adolfo Bronstein Kathleen E Cullen Peter J Goadsby Thomas Lempert Sudhir Kothari Phang Boon Lim Mns Magnusson Hani J Marcus Michael Strupp Susan L Whitney Source Type: research

Cerebral collaterals and stroke in patients with isolated carotid artery dissections
Publication date: Available online 11 January 2020Source: Journal of Clinical NeuroscienceAuthor(s): Ching-Jen Chen, Ilana E. Green, Bradford B. Worrall, Andrew M. SoutherlandAbstractTo investigate potential association between collateral arterial supply and stroke in patients with isolated internal carotid artery dissection (iCeAD). We hypothesized a lower risk of stroke in patients with more robust collateral supply. This is a single-center, retrospective review of iCeAD patients between 1994 and 2018. iCeAD patients with sufficient neuroimaging data were included. Patients were categorized based on cerebral infarction (...
Source: Journal of Clinical Neuroscience - January 13, 2020 Category: Neuroscience Source Type: research

Endovascular management of iatrogenic dissection into the petrous segment of the internal carotid artery during mechanical thrombectomy for acute stroke
Publication date: Available online 10 December 2019Source: Journal of Clinical NeuroscienceAuthor(s): David I. Bass, Melanie Walker, Louis J. Kim, Michael R. LevittAbstractIatrogenic dissection of the internal carotid artery is a well-known complication that can occur during mechanical thrombectomy for acute stroke. The vast majority of these injuries are limited to the cervical segment, and only in exceptional circumstances do they require surgical intervention. In the present case, extension of the lesion into the petrous segment of the carotid artery resulted in an acute neurologic decline necessitating emergent endovas...
Source: Journal of Clinical Neuroscience - December 11, 2019 Category: Neuroscience Source Type: research

Endovascular treatment of acute tandem occlusion strokes and stenting first experience
This study demonstrates the radiologic and clinical findings, etiologies and intervention strategy in 8 acute ischemic stroke patients with tandem occlusions. The mean age was 57 and mean NIHSS score was 19. Stent-assisted thrombectomy (SAT) was performed on all of the patients. Additionally, 6 patients underwent carotid artery stenting before SAT. Recanalization with TICI≥2b was attained in 7/8 patients. The 90thday median mRS was 2 and mortality was 1/8. The etiologies of the tandem occlusions were either extracranial high grade ICA stenosis/occlusion or cervical ICA dissection. When the stent-first approach was applie...
Source: Journal of Clinical Neuroscience - October 9, 2017 Category: Neuroscience 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

Migraine and Stroke: What ’s the Link? What to Do?
AbstractMigraine and stroke are common, disabling neurologic disorders, with a high socioeconomic burden. A link between them has been proposed years ago, and various theories have been proposed to explain this bidirectional relation. However, the precise causes remain unclear. We briefly summarize existing hypotheses of this correlation seeking for recommendations for stroke prevention in migraineurs, if any exist. Among the strongest suggested theories of migraine –stroke association are cortical spreading depression, endovascular dysfunction, vasoconstriction, neurogenic inflammation, hypercoagulability, increased pre...
Source: Current Neurology and Neuroscience Reports - March 9, 2017 Category: Neuroscience Source Type: research