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Vertebral artery dissect

Soo Young Yun, Young Jin Heo, Hae Woong Jeong, Jin Wook Baek, Hye Jung Choo, Jung Hwa Seo, Sung Tae Kim, Ji Young Lee, Sung Chul Jin
Background Acute ischemic stroke (AIS) more frequently develops in patients with intracranial vertebral artery dissection (VAD) than extracranial VAD, and is associated with possible poor clinical outcomes. The aim of this study is to compare high-resolution magnetic resonance imaging (HR-MRI) findings and clinical features of VAD with and without AIS. Methods Twenty-nine lesions from 27 patients (15 male and 12 female patients; age range = 28-73 years) who underwent diffusion MRI and 3T HR-MRI within seven days were included...
January 1, 2018: Neuroradiology Journal
Peter Brukner, Thomas J Gara, Lauren V Fortington
OBJECTIVE: To undertake a historical review of direct trauma-related deaths in Australian cricket, both organised and informal. DESIGN, SETTING AND PARTICIPANTS: We conducted an extensive search of digitised print media (three databases) and traditional scientific literature (two databases) for on-field cricket incidents in Australia that resulted in deaths during the period 1858-2016. Main outcomes and measures: Numbers of cricket-related deaths by decade; type of cricket match (organised match or training, or informal play); site of fatal injury (eg, head, chest); activity at the time of the incident (eg, batting, fielding, watching)...
March 26, 2018: Medical Journal of Australia
Mayuko Motomura, Koichi Watanabe, Yoko Tabira, Joe Iwanaga, Wakako Matsuuchi, Daichi Yoshida, Tsuyoshi Saga, Koh-Ichi Yamaki
We encountered a case of duplicated right vertebral artery during an anatomical dissection course for medical students in 2015. Two vertebral arteries were found in the right neck of a 91-year-old female cadaver. The proximal leg of the arteries arose from the area between the right subclavian artery and the right common carotid artery that diverged from the brachiocephalic artery. The distal leg arose from the right subclavian artery as expected. The proximal leg entered the transverse foramen of the fourth cervical vertebra and the distal leg entered the transverse foramen of the sixth cervical vertebra...
March 16, 2018: Kurume Medical Journal
Gabriel DeVela, J Michael Taylor, Bin Zhang, Luke L Linscott, Alan M Chen, Kunal B Karani, Andrew Furthmiller, James L Leach, Sudhakar Vadivelu, Todd Abruzzo
BACKGROUND AND PURPOSE: Quantitative arterial tortuosity (QAT) is a ratio of vessel length between 2 points to the shortest linear distance between same points. QAT has been reported as an imaging biomarker of arteriopathy in pediatric arterial ischemic stroke (AIS) because of dissection and transient cerebral arteriopathy. We sought to determine whether QAT abnormalities are present in other subtypes of pediatric AIS. METHODS: Children with AIS-absent conventional biomarkers of arteriopathy and case-controls who underwent magnetic resonance angiography were classified by stroke mechanism...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Wataro Tsuruta, Tetsuya Yamamoto, Go Ikeda, Masayuki Sato, Yoshiro Ito, Tomoji Takigawa, Aiki Marushima, Yasunobu Nakai, Yuji Matsumaru, Akira Matsumura
BACKGROUND: Endovascular surgery for vertebral artery dissections (VADs) carries the risk of spinal cord infarction (SCI). Although SCI in the region of the anterior spinal artery (ASA) has been reported, SCI in the region of the posterior spinal artery (PSA) is rare. OBJECTIVE: To investigate PSA infarction after endovascular surgery for VAD. METHODS: Infarction in the region of the PSA after endovascular surgery for VADs carried out in consecutive 21 cases was investigated...
March 9, 2018: Operative Neurosurgery (Hagerstown, Md.)
Nupoor Narula, Daniella Kadian-Dodov, Jeffrey W Olin
Fibromuscular dyplasia (FMD) is an under-recognized non-atherosclerotic, non-inflammatory arteriopathy that occurs most commonly in middle-aged women, but may affect individuals of all age groups. FMD may result in stenosis, aneurysm, dissection, occlusion, or arterial tortuosity. Recently published data demonstrated a genetic association of FMD with a variant in the phosphatase and actin regulator 1 gene (PHACTR1), substantiating that the pathogenesis of this condition has genetic contribution. The renal and extracranial carotid and vertebral arteries are most often involved, although any arterial bed may be affected...
March 10, 2018: Progress in Cardiovascular Diseases
Lidija Kocbek, Mateja Rakuša
PURPOSE: A common trunk of the posterior intercostal arteries originating from the descending thoracic aorta is normally an anatomical variation. A search through the literature disclosed the frequencies of common trunks variations among population, but no information relates to particular topic of simultaneous multiple common trunks of the PIA present in individuals. METHODS: A total of 396 intercostal spaces were dissected in 44 cadavers from the vertebral body to the mid-axillary line to observe a common trunk of the paired posterior intercostal artery at the level from T2 to T11 intercostal space...
March 12, 2018: Surgical and Radiologic Anatomy: SRA
Tsunehiko Konomi, Kota Suda, Satoko Matsumoto, Miki Komatsu, Masahiko Takahata, Norimasa Iwasaki, Akio Minami
Introduction: There are considerable risks for vertebral artery (VA) injury in case of corrective surgery for a severe and rigid cervical kyphotic deformity. This case report describes a rare case of surgical management for pre-existing traumatic rigid cervical kyphosis associated with unilateral VA occlusion. Case presentation: A 73-year-old male fell down and injured his neck. He was referred to our hospital 10 months after injury because his degree of head drop progressed gradually to a chin-on-chest position such that he could not look straight forward...
2018: Spinal Cord Series and Cases
David F Pinal-Garcia, Carlos M Nuno-Guzman, Maria E Gonzalez-Gonzalez, Tomas R Ibarra-Hurtado
Background: The celiac artery, celiac axis or celiac trunk is the first major abdominal branch of the aorta. Anatomic variations and accessory vessels have been reported with variable percentages. The purpose of this study was to report the pattern of the celiac trunk and its anatomic variations in a sample of Mexican population. Methods: Celiac trunk dissection was performed in 140 fresh cadavers. Cadavers of Mexican subjects aged 18 years and older were included...
April 2018: Journal of Clinical Medicine Research
Lijuan Yang, Haitao Ran
Vertebral artery dissection (VAD) is not uncommon in the young adult population. Owing to the various clinical manifestations; the diagnosis of VAD mainly depends on imaging examinations. Ultrasound has found an increasingly wide utilization in the diagnosis of VAD because of the continuous improvement in the resolution of ultrasonic instruments and accessibility.We retrospectively collected the data of patients with a US-proven extracranial vertebral artery dissection. In accordance with the sonographic findings, all patients were classified as having intramural hematoma, double-lumen dissection, and occlusion dissection...
March 2018: Medicine (Baltimore)
Arijana Lovrenčić-Huzjan, Marijana Bosnar-Puretić, Vlasta Vuković-Cvetković, Vanja Bašić Kes
In a certain percentage of patients with craniocervical artery dissection, dissections affect multiple arteries. Some investigators consider that the dissections diagnosed as multiple might have occurred sequentially within a short time frame. We describe an oligosymptomatic patient with bilateral progressive vertebral artery dissection. Careful history taking added new data on transient left arm weakens two months earlier, as a possibility of the earlier disease onset.
September 2017: Acta Clinica Croatica
Alvaro Campero, Juan F Villalonga, Ramiro Lopez Elizalde, Pablo Ajler
BACKGROUND: A critical step in the far lateral approach (FLA) is the exposure of V3 segment of the vertebral artery (VA), located in the depth of the suboccipital triangle (SOT). A safe exposure of the SOT is achieved by means of a plane-by-plane dissection, which carries the risk of devascularization. A suitable alternative is to lift a cutaneous muscle flap including the 3 first muscle planes, and leave the deepest plane (SOT) attached to the skull base. To achieve this, it is necessary to have superficial anatomic repairs to help us identify our cleavage site...
February 22, 2018: World Neurosurgery
Josep M Casadesús, Fernando Aguirre, Ana Carrera, Pere Boadas-Vaello, Maria T Serrando, Francisco Reina
The purpose of this study was to suggest modifications of autopsy techniques in order to improve post-mortem diagnosis of arterial gas embolism (AGE) based on multidisciplinary investigation of SCUBA diving fatalities. Five adult human cadavers from the voluntary donation program of the Human Anatomy Laboratory, and eight judicial autopsied bodies of SCUBA divers from the Forensic Pathology Service were assessed. Before performing any autopsies, we accessed the diving plan and the divers' profiles for each case...
February 19, 2018: Forensic Science, Medicine, and Pathology
Misato Kawaguchi, Kouhei Nii, Kimiya Sakamoto, Kanae Kawahara, Ritsurou Inoue, Fumihiro Hiraoka, Yusuke Morinaga, Takafumi Mitsutake, Hayatsura Hanada, Masanori Tsutsumi
A 73-year-old man was admitted at another hospital after a traffic accident. The diagnosis was cervical vertebral fracture. Despite conservative treatment, 5 days later he manifested dysarthria due to cerebellar infarction and was transferred to our hospital. Imaging studies revealed right vertebral arterial dissection at the level of the axial fracture. We performed percutaneous transluminal angioplasty with stenting to address his subacute vertebral artery dissection prior to treating the cervical vertebral fracture using external fixation...
February 2018: No Shinkei Geka. Neurological Surgery
Karanarak Urasyanandana, Dittapong Songsang, Taweesak Aurboonyawat, Ekawut Chankaew, Pattarawit Withayasuk, Anchalee Churojana
Methods Patients with cerebral artery dissections were reviewed in a hospital setting from 2008 to 2015. Clinical presentations, lesion locations, treatment modalities, functional outcomes, and mortality were reviewed. Parent artery occlusion was the first choice for surgery or endovascular treatment of a hemorrhagic dissecting cerebral artery. Endovascular or surgical reconstructive treatment was indicated in patients whose parent artery could not be occluded. Favorable functional outcomes were determined using modified Rankin Scale (mRS) scores of 0-2...
January 1, 2018: Interventional Neuroradiology
Juan A Sanchis-Gimeno, Susanna Llido, Marcos Miquel-Feutch, Laura Quiles-Guinau, Luis Rios, Mayte Murillo-Llorente, Marcelino Perez-Bermejo, Shahed Nalla
BACKGROUND: The arcuate foramen (AF), or ponticulus posticus, is an anatomic variant of the first cervical vertebra that consists of a complete or partial osseous bridge over the groove for the vertebral artery and extends from the posterior aspect of the superior articular facet to the superior lateral border of the posterior arch. The AF has been associated with clinical symptoms, such as headache, migraine, neck pain, shoulder pain, arm pain, and vertebral artery dissection. We aimed to test whether the prevalence of the AF has decreased in the modern human population over the past centuries as a result of reduction in inbreeding and endogamy...
February 2018: World Neurosurgery
Makoto Katsuno, Akira Matsuno
Background: Although vertebral artery (VA) dissecting aneurysms are treated by direct or endovascular surgery, some disadvantages are associated with each surgery. Therefore, the type of surgery should be selected based on the condition of the aneurysm. We performed aneurysm trapping by endovascular surgery via the contralateral VA after proximal direct ligation with bypass to prevent complications as well as achieve complete treatment. Case Description: We attempted to insert a distal clip to achieve complete trapping of the ruptured VA dissecting aneurysm after proximal ligation with occipital artery-posterior inferior cerebellar artery (PICA) anastomosis; however, the operative field was limited by the existence of lower cranial nerves, brain swelling, and tortuosity of VA...
2018: Surgical Neurology International
Andreas Schicho, Lukas Luerken, Ramona Meier, Antonio Ernstberger, Christian Stroszczynski, Andreas Schreyer, Lena-Marie Dendl, Stephan Schleder
Purpose: The aim of this study was to evaluate the true incidence of cervical artery dissections (CeADs) in trauma patients with an Injury Severity Score (ISS) of ≥16, since head-and-neck computed tomography angiogram (CTA) is not a compulsory component of whole-body trauma computed tomography (CT) protocols. Patients and methods: A total of 230 consecutive trauma patients with an ISS of ≥16 admitted to our Level I trauma center during a 24-month period were prospectively included...
2018: Therapeutics and Clinical Risk Management
Stephen N Dunay, Michael D Perreault, Lindsay K Grubish
Vertebral artery dissection is of special clinical importance because of its often-delayed presentation and the risk of potentially permanent neurological deficit, or even death, as a result of injury. Once a rarely discovered injury, the better availability and use of computed tomography and magnetic resonance imaging have contributed to an increased incidence. Early diagnosis and treatment can almost eliminate the threat of acute cerebral vascular injury and save lives. In this report, we review a case of delayed traumatic vertebral artery dissection and discuss the key clinical findings and management strategies...
February 5, 2018: Military Medicine
Mutsumi Fujii, Miki Ohgushi, Takaaki Chin
A 16-year-old boy presented with multiple posterior circulation ischemic strokes resulting from vertebral artery (VA) dissection. Three-dimensional computed tomography showed aberrant sub-occipital bone protuberance, proximal to the VA dissection. Since the patient was a habitual neck cracker, VA dissection was thought to result from the impact shock of the rotational head movement. This could be due to either the osseous prominence or the compression between the prominence and the C1. Although it is a rare etiology of Bow Hunter's syndrome, VA dissection due to sub-occipital bone spur because of neck cracking should be considered in the diagnosis of Bow Hunter's syndrome in juvenile patients...
February 6, 2018: British Journal of Neurosurgery
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