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cervical arterial dissection

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https://www.readbyqxmd.com/read/29323631/endovascular-treatment-with-tirofiban-during-the-acute-stage-of-cervical-spinal-cord-infarction-due-to-vertebral-artery-dissection
#1
Yuanling Wu, Wenxian Li, Xiaomei Xie, Zhen Jing, Weibiao Lu, Li'an Huang
CONTEXT: Cervical spinal cord infarction is a rare and severe complication of vertebral artery dissection (VAD). We report a case of VAD in an acute stage followed by cervical spinal cord infarction that was treated using direct endovascular tirofiban infusion via digital subtraction angiography (DSA) monitoring. FINDINGS: A 48-year-old man presented with vertigo, neck pain, numbness and weakness in four limbs with subsequent cardiac and respiratory arrest. Neurological examination revealed hypoesthesia below the neck with grade one myodynamia on the right side of the limbs and zero on the left side...
January 11, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29320926/brain-perfusion-fixation-in-male-pigs-using-a-safer-closed-system
#2
Gracia U Musigazi, Stéphanie De Vleeschauwer, Raf Sciot, Eric Verbeken, Bart Depreitere
Tissue fixation methods are well established for rodents, but not for large animals. We present a simple technique for in situ brain perfusion fixation in a male porcine model, using cervical vessels for inflow and outflow and achieving a closed system. Thirty-four pigs, aged 4.7 ± 0.6 months and weighing 60.7 ± 10.9 kg, were anaesthetised and mechanically ventilated. The ipsilateral common carotid artery and external jugular vein were dissected and constituted the inflow and outflow access, respectively...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29277281/yield-of-computed-tomography-ct-angiography-in-patients-with-acute-headache-normal-neurological-examination-and-normal-non-contrast-ct-a-meta-analysis
#3
Imanda M E Alons, Ben F J Goudsmit, Korne Jellema, Marianne A A van Walderveen, Marieke J H Wermer, Ale Algra
BACKGROUND: Patients with acute severe headache, normal neurological examination, and a normal noncontrast head computed tomography (NCCT) may still have subarachnoid hemorrhage, cerebral venous thrombosis (CVT), cervical arterial dissection, or reversible cerebral vasoconstriction syndrome (RCVS). Computed tomography angiography (CTA) is used increasingly in the emergency department for evaluating this, but its added value remains controversial. METHODS: We retrospectively collected data on the diagnostic yield of CTA in patients with acute severe headache, normal neurological examination, and normal NCCT who received additional CTA in the acute phase in 2 secondary referral centers for vascular neurology...
December 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29246556/uterus-transplantation-robotic-surgeon-perspective
#4
Hubert Fornalik, Nicole Fornalik
OBJECTIVE: To study the safety and feasibility of robotic dissection of deep pelvic vessels as applied to the robotic harvesting of a uterus from live transplant donor. DESIGN: Surgical video. SETTING: Gynecologic oncology practice of a tertiary community cancer center. PATIENT(S): Two patients undergoing robotic nerve-sparing radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage Ib1 cervical cancer...
December 12, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29224120/spontaneous-cervical-artery-dissection-is-accompanied-by-a-hypercoagulable-state-and-simultaneous-inflammatory-condition
#5
Johann Otto Pelz, Kristian Harms, Michael Metze, Dominik Michalski
BACKGROUND: Spontaneous cervical artery dissections (sCAD) are often preceded by infections. However, existing data about inflammatory parameters remained inconsistent. Remarkably, concurrent information about the coagulation system, whose affection seems also reasonable to cause ischaemic events, are still lacking in sCAD patients. Thus, this study explores the association between the inflammatory and coagulation system in patients with sCAD. METHODS: The parameters leukocyte and thrombocyte count, C-reactive protein, fibrinogen, D-dimer, activated partial thromboplastin time (aPTT) and prothrombin time were extracted from hospital-based medical records of patients (n = 60) with sCAD and compared with those of a control group (n = 97) from a prospective observational stroke study...
December 9, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29171361/canadian-stroke-best-practice-recommendations-secondary-prevention-of-stroke-sixth-edition-practice-guidelines-update-2017
#6
Theodore Wein, M Patrice Lindsay, Robert Côté, Norine Foley, Joseph Berlingieri, Sanjit Bhogal, Aline Bourgoin, Brian H Buck, Jafna Cox, Dion Davidson, Dar Dowlatshahi, Jim Douketis, John Falconer, Thalia Field, Laura Gioia, Gord Gubitz, Jeffrey Habert, Sharon Jaspers, Cheemun Lum, Dana McNamara Morse, Paul Pageau, Mubeen Rafay, Amanda Rodgerson, Bill Semchuk, Mukul Sharma, Ashkan Shoamanesh, Arturo Tamayo, Elisabeth Smitko, David J Gladstone
The 2017 update of The Canadian Stroke Best Practice Recommendations for the Secondary Prevention of Stroke is a collection of current evidence-based recommendations intended for use by clinicians across a wide range of settings. The goal is to provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations include those related to diagnostic testing, diet and lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet and anticoagulant therapies, carotid artery disease, atrial fibrillation, and other cardiac conditions...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29167221/cervical-oesophageal-perforation-secondary-to-food-consumption-in-a-well-appearing-patient
#7
Alexander L Schneider, Katherine E Hicks, Akihiro J Matsuoka
A 71-year-old woman presented to the emergency department 8 days after ingesting fish with mild neck pain but otherwise demonstrated no signs of infection. X-rays were negative but CT imaging demonstrated a curvilinear radiodense object extending from the posterior cervical oesophagus through the right thyroid lobe terminating in the neck just a few millimetres from the external carotid artery. Rigid oesophagoscopy and direct laryngoscopy were negative and the neck was explored for the foreign body, which ultimately was encountered after a painstaking dissection of the right neck that included skeletonisation of the recurrent laryngeal nerve...
November 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29163750/long-acting-liposomal-bupivacaine-for-percutaneous-sympathetic-stellate-ganglion-blockade-a-technical-note
#8
Adnan I Qureshi, Muhammad A Waqas, Vikram Jadhav, Muhammad A Saleem, Jeff Campbell, Shawn S Wallery
Introduction: We describe the use of long acting liposomal bupivacaine for percutaneous stellate ganglion blockade to treat severe headaches following internal carotid artery dissection. Methods: A 43-year old woman developed right-sided refractory headache after right internal carotid artery dissection. Patient underwent percutaneous stellate ganglion block using bupivacaine hydrochloride (0.25%-20 ml) in the past with short acting relief. Liposomal bupivacaine (EXPAREL) 13...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29163749/isolated-extracranial-vasospasm-and-intracranial-dissection-an-unusual-imaging-manifestation-of-reversible-cerebral-vasoconstriction-syndrome
#9
Fatmah Al Zahmi, Sumeet G Dua, Miral D Jhaveri, Shawna Cutting
Reversible cerebral vasoconstriction syndrome (RCVS) is a distinct clinical syndrome characterized by thunderclap headache and reversible cerebral vasoconstriction. An association between RCVS and arterial dissection has emerged in recent years, where dissection typically involves the cervical vertebral arteries. In this vignette, we describe isolated reversible vasoconstriction, involving the extracranial arteries and intracranial dissection-a combination hitherto never reported.
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29152471/internal-carotid-artery-dissection-in-brazilian-jiu-jitsu
#10
Zeferino Demartini, Maxweyd Rodrigues Freire, Roberto Oliver Lages, Alexandre Novicki Francisco, Felipe Nanni, Luana A Maranha Gatto, Gelson Luis Koppe
Carotid artery dissection is a significant cause of stroke in young patients. It may be asymptomatic and go undiagnosed, or minimal transient manifestations may follow, commanding a higher index of suspicion than ordinarily exists to avoid misdiagnosis. Reported herein is a 27-year-old man who suffered extracranial internal carotid artery dissection while practicing a Brazilian Jiu-Jitsu submission maneuver. The patient's condition suddenly deteriorated one week later due to distal embolization and stroke. Despite endovascular treatment, with stenting of the cervical carotid artery, neurologic deficits remained...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29142493/cervical-arterial-fibromuscular-dysplasia-in-a-biethnic-population-a-retrospective-study-in-the-u-s-mexican-border
#11
Ihtesham A Qureshi, Gustavo J Rodriguez, Tatiana Chacon-Quesada, Gavito-Higuera Jose, Salvador Cruz-Flores, Alberto Maud
Background  There have been studies trying to characterize Fibromuscular Dysplasia (FMD); however, most of them are based in mainly non-Hispanic sample. The objective of this study is to better understand the epidemiology and clinical characteristics of craniocervical FMD in the Hispanic population. Methods  We retrospectively reviewed the cerebral angiograms performed in our center in a period of 3.5 years under any indication looking for angiographic patterns of FMD. Exclusion criteria consisted of cases in which the first angiogram was done when the patients were younger than 18 years...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29133152/laparoscopic-assisted-uterus-retrieval-from-live-organ-donors-for-uterine-transplant
#12
Shailesh Puntambekar, Milind Telang, Pankaj Kulkarni, Sanjeev Jadhav, Ravindra Sathe, Neeta Warty, Seema Puntambekar, Sandesh Kade, Mangesh Panse, Nikhil Agarkhedkar, Giriraj Gandhi, Manoj Manchekar, Hirav Parekh, Kajal Parikh, Riddhi Desai, Mehul Mehta, Mihir Chitale, Sambit Nanda
OBJECTIVE: The authors present the first ever laparoscopic assisted uterus retrieval in live donor for uterus transplant. DESIGN: A step-by-step surgical demonstration SETTING: Galaxy CARE Laparoscopy Institute, Pune, India PATIENT(S): Two patients, ages 21 and 26 with Mayer Rokitansky Kuster Hauser (MRKH) syndrome and Ashermann's syndrome respectively, with their mothers as donors. INTERVENTION(S): A Twelve member team was formed. After review of available literature on uterine transplant a protocol was formulated and submitted to the IRB...
November 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29124354/parathyroid-thyroid-and-recurrent-laryngeal-nerve-anatomy-in-an-indian-rhinoceros-rhinoceros-unicornis
#13
R Udelsman, S B Citino, M Prasad, P I Donovan, D V Fredholm
INTRODUCTION: The parathyroid gland was first identified in the Indian rhinoceros in 1849 by Sir Richard Owen. We performed a necropsy in an Indian rhinoceros, recapitulating Owen's dissection and display what appear to be the initial identification of the recurrent laryngeal nerve in situ and the anatomy and histology of the largest rhinoceros parathyroid glands yet identified. MATERIALS AND METHODS: Patrick T. Rhino, a 41-year-old Indian rhinoceros was born in 1974...
November 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29118792/anchoring-pipeline-flow-diverter-construct-in-the-treatment-of-traumatic-distal-cervical-carotid-artery-injury
#14
Krishna Amuluru, Fawaz Al-Mufti, William Roth, Charles J Prestigiacomo, Chirag D Gandhi
Background: Traumatic extracranial internal carotid artery (ICA) dissections are uncommon and can be difficult to treat. Thinning of adventitia and dilatation may occur following arterial dissection, thus resulting in a fusiform pseudoaneurysm, which can subsequently cause bleeding, expanding, or pulsatile hematoma. Currently, medical management with anticoagulation remains the first line of treatment and yields good outcomes in 75% of cases with a mortality rate of 3-4%. Endovascular intervention is indicated with failure of medical therapy, progressive enlargement of a traumatic pseudoaneurysm, acute flow-related infarcts due to vessel occlusion, or when anticoagulation is contraindicated due to risk of pseudoaneurysm rupture and hemorrhage...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#15
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29114928/a-new-substitute-for-formalin-application-to-embalming-cadavers
#16
Yoshinori Haizuka, Miki Nagase, Satoshi Takashino, Yasushi Kobayashi, Yoshihisa Fujikura, George Matsumura
The development of formalin-free fixatives is an urgent issue in gross anatomy because of the health hazard and the tissue-hardening actions of formalin. We recently identified the fixative, antimicrobial, and preservative effects of N-vinyl-2-pyrrolidone (NVP), a precursor of the water-soluble macromolecular polymer polyvinylpyrrolidone, in animal experiments. The aim of the present study is to investigate whether NVP solution can be used as an alternative to formalin in human cadaveric dissection. Twelve donated cadavers were infused with NVP via the femoral and common carotid arteries using a peristaltic pump...
November 7, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/29104105/bilateral-superior-cervical-ganglionectomy-attenuates-the-progression-of-%C3%AE-aminopropionitrile-induced-aortic-dissection-in-rats
#17
Huan Liu, Xiangxiang Zheng, Linfei Zhang, Xuechao Yang, Yongfeng Shao, Shijiang Zhang
AIMS: Aortic dissection (AD) represents one of the most common aortic emergencies with high incidence of morbidity and mortality. Clinical studies have shown that the increased excitability of the sympathetic nerve may be associated with the formation of AD. In this study, we examined the effects of bilateral superior cervical sympathectomy (SCGx) on the progression of β-aminopropionitrile (BAPN)-induced AD in rats. MAIN METHODS: Sprague-Dawley rats were randomly divided into three groups, including BAPN, BAPN+SCGx and control groups...
November 2, 2017: Life Sciences
https://www.readbyqxmd.com/read/29100856/recanalization-after-extracranial-dissection-effect-of-antiplatelet-compared-with-anticoagulant-therapy
#18
Preethi Ramchand, Michael T Mullen, Aaron Bress, Robert Hurst, Scott E Kasner, Brett L Cucchiara, Steven R Messé
BACKGROUND: Cervical arterial dissection is a leading cause of stroke in young patients, yet optimal management remains controversial. Existing studies focusing on recurrent stroke were underpowered to demonstrate differences between antithrombotic strategies. Vessel recanalization is a more prevalent outcome and is potentially clinically important. We aimed to assess recanalization rates with anticoagulation compared with antiplatelet therapy. METHODS: We studied a single-center retrospective cohort of patients with extracranial carotid or vertebral artery dissection...
October 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29050892/traumatic-vertebral-artery-dissection-in-high-school-rugby-players-a-report-of-two-cases
#19
Satoshi Suzuki, Ryosuke Tsuchimochi, Gorou Abe, Iwae Yu, Takuya Inoue, Hideaki Ishibashi
Traumatic vertebral artery dissection (VAD) has been reported in various types of sports and recreation. However, there have been no reports of VAD in rugby players, except for those with cervical spine injuries. We experienced two cases of VAD without cervical spine injuries in high school rugby players. Attention should be paid to protect youth rugby players from VAD.
October 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29040971/characteristics-and-outcomes-of-vertebrobasilar-artery-dissection-with-accompanied-atherosclerosis
#20
Chun Chien, Feng-Chi Chang, Hui-Chi Huang, Jui-Yao Tsai, Chih-Ping Chung
BACKGROUND: With the popularity of MRI use, vertebrobasilar artery dissection (VBD) has been found more frequently in patients with posterior circulation ischemic stroke (PCS). The relationship between VBD and atherosclerosis is unknown. The present study aimed to prove the hypothesis that PCS with pure VBD (p-VBD) and with VBD and accompanied cervical or cerebral artery atherosclerosis (a-VBD) have distinct manifestations. METHODS: Patients with VBD-related PCS who were prospectively enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and August 31, 2014 were recruited for the present study...
October 17, 2017: Cerebrovascular Diseases Extra
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