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Traumatic cerebral artery dissection

L Jackers, L Davin, B Falque, M Magnée, L Piérard
Spontaneous Coronary Artery Dissection (SCAD) is a non-traumatic and non-iatrogenic separation of the coronary arterial wall. Although uncommon, it should be suspected in any young patient with acute myocardial infarction especially without risk factor of cardiovascular disease. Early coronary angiography is essential in the diagnosis of SCAD. Fibromuscular dysplasia is a rare cause of SCAD, particularly encountered in young women. This is a nonatherosclerotic and noninflammatory vascular disease. Fibromuscular dysplasia may cause stenosis, aneurysm, dissection and / or occlusion of arteries...
October 2016: Revue Médicale de Liège
Christopher P Johnson, Mike Murphy, George A Johnson, Stephen M Wills, Jonathan E Medcalf
Identifying the site of vascular bleeding in fatal cases of traumatic basal subarachnoid hemorrhage (TBSAH) is important, but can be very difficult to achieve when there is extensive blood clot in the posterior cranial fossa. Post mortem angiography in these circumstances has been reported previously but with mixed results, and is rarely used in current practice within the United Kingdom. We have developed a simple and effective post mortem angiography method, using fluoroscopy and clear modern contrast medium, suitable for use in the autopsy room...
March 2017: Forensic Science, Medicine, and Pathology
Vikas Acharya, Suresh Chandrasekaran, Sujit Nair
INTRODUCTION: The authors present an interesting case of a 19-year-old male who presented as a polytrauma patient following a fall from a height. PRESENTATION OF CASE: He was initially managed on the intensive care unit with intracranial pressure bolt monitoring after being intubated and sedated and having his other traumatic injuries stabilized. Upon attempting to wean sedation and extubation a repeat CT scan of the head was undertaken and showed a new area suggested of cerebral infarction, this was a new finding...
2016: International Journal of Surgery Case Reports
Joanne May Jenkins, Joel Norton, Timothy Hampton, Robert Weeks
A 55-year-old man was working in a trench when the wall collapsed in on him, pinning him to the wall. On arrival in the emergency department the patient began reporting of right-sided headache. Neurological examination revealed left-sided reduced sensation with weakness. Whole-body CT scan showed right-sided flail chest and bilateral haemothorax as well as loss of flow and thinning of the distal right internal carotid artery (ICA) and loss of grey white matter differentiation in keeping with traumatic ICA dissection with a right middle cerebral artery (MCA) infarct...
September 20, 2016: BMJ Case Reports
Motohiro Nomura, Akira Tamase, Tomoya Kamide, Kentaro Mori, Syunsuke Seki, Yu Iida, Kei-Ichiro Suzuki, Takae Aoki, Ken-Ichi Hirano, Mitsuyuki Takahashi, Yuichi Kawabata, Tatsu Nakano, Hiroki Taguchi
We report a patient with a traumatic middle cerebral artery dissection, which showed hyperperfusion in the territory supplied by the left middle cerebral artery. A 45-year-old man experienced speech disturbance and motor weakness in his right hemibody on the day following mild head trauma. His symptoms worsened on the fourth day. Magnetic resonance imaging showed narrowing in the left M1 portion of the middle cerebral artery. Angiography showed narrowing and dilatation in the left middle cerebral artery trunk...
October 2016: Neuroradiology Journal
Jose Enrique Alonso Formento, Jose Luis Fernández Reyes, Blanca Mar Envid Lázaro, Teresa Fernández Letamendi, Ryth Yeste Martín, Francisco José Jódar Morente
Internal carotid artery dissection (ICAD) is a rare entity that either results from traumatic injury or can be spontaneously preceded or not by a minor trauma such as sporting activities. It represents a major cause of stroke in young patients. The diagnosis should be suspected with the combination of Horner's syndrome, headache or neck pain, and retinal or cerebral ischaemia. The confirmation is frequently made with a magnetic resonance angiography (MRA). Although anticoagulation with heparin followed by vitamin-K-antagonists is the most common treatment, there is no difference in efficacy of antiplatelet and anticoagulant drugs at preventing stroke and death in patients with symptomatic carotid dissection...
2016: Case Reports in Neurological Medicine
Kevin Hargrave, Blaine Hoppe, Joan Wojak, Paula Sharkey, James Godchaux, Orlando Diaz
The authors present an unusual case of a transorbital penetrating injury of the internal carotid artery and brainstem. A young man accidentally ran into a 10-foot long citizens band (CB) antenna, and presented to the emergency department with nausea, dizziness and right periorbital ecchymosis. The nature and full extent of the injury were not appreciated at the time of initial examination and computed tomography scan. Magnetic resonance imaging subsequently demonstrated an unusual brainstem lesion. Neurology consultation was obtained...
May 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Kyoung Hee Han, Ji Youn Park, Seung-Kee Min, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
Thromboembolic complications (TECs) are clinically important sequelae of nephrotic syndrome (NS). The incidence of TECs in children is approximately 2%-5%. The veins are the most commonly affected sites, particularly the deep veins in the legs, the inferior vena cava, the superior vena cava, and the renal veins. Arterial thrombosis, which is less common, typically occurs in the cerebral, pulmonary, and femoral arteries, and is associated with the use of steroids and diuretics. Popliteal artery thrombosis in children has been described in cases of traumatic dissection, osteochondroma, Mycoplasma pneumoniae infection, and fibromuscular dysplasia...
May 2016: Korean Journal of Pediatrics
Sang-Youl Yoon, Seong-Hyun Park, Jeong-Hyun Hwang, Sung-Kyoo Hwang
We report a case of multiple symptomatic cerebral infarctions from a traumatic vertebral artery dissection (VAD) after cervical fractures. A 73-year-old man was admitted with stuporous mentality and left hemiparesis after a motor-vehicle accident. A brain computed tomography (CT) scan at admission showed a traumatic subarachnoid hemorrhage on the left parietal lobe. A cervical CT scan showed left lateral mass fractures on C2, C5, and C6, involving the transverse foramen. Cervical spine magnetic resonance imaging (MRI) revealed loss of signal void on the left vertebral artery...
April 2016: Korean Journal of Neurotrauma
Yoshifumi Mizobuchi, Shinji Nagahiro
We review current topics in sport-related head injuries including acute subdural hematoma (ASDH), traumatic cerebrovascular disease, cerebral concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football and Japanese judo. Rotational acceleration can cause either cerebral concussion or ASDH due to rupture of a parasagittal bridging vein. Although rare, approximately 80% of patients with cerebral infarction due to sport participation are diagnosed with ischemia or infarction due to arterial dissection...
April 2016: Korean Journal of Neurotrauma
Felix Wei, Karl T Diedrich, Heather J Fullerton, Gabrielle deVeber, Max Wintermark, Jacquie Hodge, Adam Kirton
BACKGROUND AND PURPOSE: Arteriopathy is the leading cause of childhood arterial ischemic stroke. Mechanisms are poorly understood but may include inherent abnormalities of arterial structure. Extracranial dissection is associated with connective tissue disorders in adult stroke. Focal cerebral arteriopathy is a common syndrome where pathophysiology is unknown but may include intracranial dissection or transient cerebral arteriopathy. We aimed to quantify cerebral arterial tortuosity in childhood arterial ischemic stroke, hypothesizing increased tortuosity in dissection...
May 2016: Stroke; a Journal of Cerebral Circulation
Xie Zhengxing, Cui Zhenwen, Sun Yuhao, Zhong Zhihong, Bian Liuguan, Sun Qingfang
Traumatic carotid artery dissection (tCAD) bears the risk of hypoperfusion inducing delayed cerebral ischemia. The lack of consensus on standard treatment of tCAD remains a great challenge. Here, we present our successes on a series of patients with delayed tCAD diagnosis and treatment using multimodality treatment strategies. We retrospectively reviewed 21 patients with tCAD treated with carotid artery stent placement or anticoagulation therapy. There were 14 dissection locations (66.67 %) which involved extracranial internal carotid artery (ICA) and seven locations (33...
July 2016: Neurosurgical Review
Shantum Misra, Corbett A Haas, Meredith August, Kyle R Eberlin
Traumatic injuries to the lip are common, but injuries that require revascularization of the lower lip are infrequent and pose a major challenge to the reconstructive surgeon. This report describes the case of a 53-year-old woman who sustained a lower lip avulsion injury, a comminuted mandibular parasymphyseal fracture, and a hyoid bone fracture secondary to a bicycle accident. Trauma workup included computed tomographic angiography of the head and neck, which did not show vascular injury. Despite successful revascularization of the lower lip, on postoperative day 11 the patient developed a large internal carotid artery dissection and middle cerebral artery stroke...
January 2016: Journal of Oral and Maxillofacial Surgery
Chang Hyun Oh, Gyu Yeul Ji, Seung Hwan Yoon, Dongkeun Hyun, Eun Young Kim, Hyeonseon Park, A Reum Jang
Vascular injury presented immediately after the penetration, but delayed onset of vascular symptom caused by an embolism or vessel dissection after cervical fusion or traumatic event is extremely rare. We present a case of a 56-year-old woman who underwent an operation for cervical fusion for type II Odontoid process fracture. She presented symptoms of seizure with hemiparesis in 6 days after the operation. Multifocal acute infarction due to an embolism from the left VA (V3 segment) dissection was observed without a definite screw breach the transverse foramen...
June 2015: Korean Journal of Spine
Joshua D Zimmerman, Danielle M McCarthy
BACKGROUND: Head injuries are a common chief complaint encountered in the emergency department (ED). A cerebrospinal fluid (CSF) leak resulting from such injuries is uncommon, but has potentially debilitating consequences if undiagnosed. CASE REPORT: A 34-year-old male patient presented to the ED with complaints of an orthostatic headache after a bicycle accident that occurred 5 days prior to presentation. He presented with a nonfocal neurologic examination. Computed tomography (CT) of the head was without significant pathology...
September 2015: Journal of Emergency Medicine
Octavia Rusu, Mihai Vasile, Ovidiu Bajenaru, Florina Antochi
Cervical artery dissection is becoming a more frequently identified cause of ischemic stroke among the young and middleaged patients. The pathogenesis of non-traumatic dissection has not been yet entirely elucidated, but certain risk factors have been reported. We present the case of a young patient with ischemic stroke in the middle cerebral artery territory secondary to internal carotid artery dissection and occlusion, in whom we identified two rarely incriminated risk factors: migraine and recent infection (pneumonia)...
June 2014: Mædica
George Kalantzis, Ilias Georgalas, Bernard Y P Chang, Chin Ong, Nabil El-Hindy
The presentation of Horner's syndrome following blunt trauma is uncommon, but is of important clinical significance. Identification of the constellation of signs of Horner's syndrome should, therefore, prompt urgent neuro-radiologic imaging. Early diagnosis and initiation of appropriate treatment can lead to excellent outcomes in the majority of cases and prevent devastating cerebral ischaemic damage. A progressive case of Horner's syndrome following blunt injury to the neck in an amateur snowboarder is presented...
May 2014: Journal of Sports Science & Medicine
G H Zoarski, R Seth
BACKGROUND AND PURPOSE: Antecedent balloon test occlusion is often performed prior to vertebral artery sacrifice, but there is limited data to suggest this adds a significant clinical benefit, especially in the setting of trauma. Furthermore, balloon test occlusion can be time-consuming, add to the technical complexity of the procedure, and increase the overall cost of treatment. The purpose of this study was to determine the safety of unilateral vertebral artery occlusion without antecedent balloon test occlusion as part of the treatment regimen in patients with traumatic vertebral artery dissection, cervical tumor, or intracranial aneurysm...
May 2014: AJNR. American Journal of Neuroradiology
Dong Hoon Shin, Ji Man Hong, Jin Soo Lee, Rezanejad Nasim, Sung Il Sohn, Suk Jae Kim, Oh Young Bang
BACKGROUND/AIMS: To better understand potential risks for vertebral artery (VA) dissection (VAD), we compared intracranial and extracranial VADs. METHODS: We analyzed consecutively admitted VAD patients over a 9-year period in whom VAD was confirmed by angiography. All patients were categorized as having intracranial or extracranial VAD, and demographic and radiological characteristics of VAD were compared. We used multivariate analysis to predict the risks for intracranial and extracranial VADs...
2014: European Neurology
Jonathon Downer, Mahendra Nadarajah, Eliza Briggs, Peter Wrigley, William McAuliffe
INTRODUCTION: The traditional view is that spontaneous extracranial internal carotid artery (ICA) dissection (CAD) extends cranially from an intimal tear located just beyond the carotid bulb. This paper demonstrates that CAD originates in and primarily involves a more distal segment of the artery. METHODS: A retrospective study of 54 dissected ICAs in 50 consecutive patients with spontaneous or traumatic CAD was undertaken. The site of the dissection, presence of ICA redundancy, rate of acute or delayed ischaemic stroke and vessel remodelling were determined...
August 2014: Journal of Medical Imaging and Radiation Oncology
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