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vertebral artery dissection

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https://www.readbyqxmd.com/read/29129766/the-treatment-of-a-spontaneous-dissecting-aneurysm-in-the-extracranial-vertebral-artery-with-covered-stent-a-case-report
#1
Ning Xu, Kun Zhang, Hao Meng, Tianyi Liu, Honglei Wang
A 13-year-old boy with a spontaneous vertebrobasilar artery dissecting aneurysm (VADA) in the extracranial artery, which was only 1 mm away from the initial segment of subclavian artery, was successfully treated with a covered-stent to block the artery of the VADA. Our experience indicates that this is a fast, reliable, effective and economical technique, particularly suitable for surgeries in settings with limited resources.
November 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29118804/hybrid-retrograde-antegrade-recanalization-of-acute-basilar-artery-occlusion
#2
James D Rossen, Edgar A Samaniego, Mishelle Paullus, Santiago Ortega-Gutierrez
Acute basilar artery (BA) occlusion has a very poor prognosis. Recanalization can be challenged by bilateral vertebral artery (VA) occlusions, arterial dissection, or advanced atherosclerotic disease. We describe a case in whom the BA was accessed and recanalized through a retrograde-antegrade approach from the anterior circulation using a large posterior communicating artery (PCOM). Once the BA had been crossed retrogradely through the PCOM, another microcatheter was advanced antegradely through the VA into the BA and right posterior cerebral artery using the "buddy-wire" technique...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29108808/fatal-intracranial-aneurysms-and-dissections-causing-subarachnoid-hemorrhage-an-epidemiological-and-pathological-analysis-of-607-legal-autopsy-cases
#3
Shinjiro Mori, Shirushi Takahashi, Akira Hayakawa, Kazuyuki Saito, Aya Takada, Tatsushige Fukunaga
BACKGROUND: There are no detailed reports, in terms of epidemiology and pathology, on intracranial aneurysms and on dissections that were found in unexpected fatal subarachnoid hemorrhage (SAH) cases. In this report we analyzed, based on large-sized medicolegal autopsy cases, the detailed epidemiology and pathological aspects of both lesions. METHODS: We analyzed 607 autopsy cases of unexpected fatal SAHs including 496 aneurysms and 111 dissections. RESULTS: The following results were obtained: (1) Patients who died of dissections were younger than those who died of aneurysms; (2) symptom prevalence rates of aneurysms were 31...
November 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29100856/recanalization-after-extracranial-dissection-effect-of-antiplatelet-compared-with-anticoagulant-therapy
#4
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/29098320/iatrogenic-vessel-dissection-in-endovascular-treatment-of-acute-ischemic-stroke
#5
Barbara Goeggel Simonetti, Justine Hulliger, Etienne Mathier, Simon Jung, Urs Fischer, Hakan Sarikaya, Johannes Slotboom, Gerhard Schroth, Pasquale Mordasini, Jan Gralla, Marcel Arnold
PURPOSE: Knowledge about the localization and outcome of iatrogenic dissection (ID) during endovascular treatment of acute ischemic stroke (AIS) is limited. We aimed to determine the frequency, clinical aspects and morphology of ID in endovascular AIS treatment and to identify predictors of this complication. METHODS: Digital subtraction angiography (DSA) of ID carried out during endovascular treatment between January 2000 and March 2012 have been re-evaluated. The ID localization and morphology were analyzed and related to the interventional techniques...
November 2, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29050892/traumatic-vertebral-artery-dissection-in-high-school-rugby-players-a-report-of-two-cases
#6
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/29040967/improvement-and-aggravation-of-spontaneous-unruptured-vertebral-artery-dissection
#7
Tomoya Shibahara, Masahiro Yasaka, Yoshiyuki Wakugawa, Koichiro Maeda, Takeshi Uwatoko, Takahiro Kuwashiro, Gregory Y H Lip, Yasushi Okada
BACKGROUND: Intracranial vertebral artery dissection (VAD) is a well-recognized cause of stroke in young and middle-aged individuals, especially in Asian populations. However, a long-term natural course remains unclear. We investigated the long-term time course of VAD using imaging findings to examine the rate and predisposing factors for improvement. METHODS: We registered 56 consecutive patients (40 males; mean age, 51.8 ± 10.7 years) with acute spontaneous VAD and retrospectively investigated neuroimaging and clinical course within 1 month and at 3 months ± 2 weeks, 6 months ± 2 weeks, and 12 months ± 2 weeks after onset to ascertain predisposing factors and time course for improvement...
October 17, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28987840/endovascular-treatment-of-ruptured-vertebrobasilar-dissecting-aneurysms-using-flow-diversion-embolization-devices-single-institution-experience
#8
Waldo R Guerrero, Santiago Ortega-Gutierrez, Minako Hayakawa, Colin P Derdeyn, James D Rossen, David Hasan, Edgar A Samaniego
OBJECTIVE: Treatment of ruptured posterior circulation dissecting aneurysms is technically challenging with potentially high morbidity and mortality. We sought to assess the safety and feasibility of using a flow diversion devices (FDD) and a specific acute antiplatelet aggregation protocol in the management of ruptured dissecting aneurysms. METHODS: Subjects with ruptured dissecting aneurysms treated during a three-year period were retrospectively identified from a prospective registry...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987426/extracranial-cervical-artery-dissections
#9
REVIEW
Jennifer J Robertson, Alex Koyfman
Cervical artery dissections (CeAD) include both internal carotid and vertebral artery dissections. They are rare but important causes of stroke, especially in younger patients. CeAD should be considered in patients with strokelike symptoms, a new-onset headache and/or neck pain, and/or other risk factors. Early imaging with computed tomography (CT) or magnetic resonance imaging (MRI) is key to making the diagnosis. Treatment may vary depending on the extent of the dissection, timing of the dissection, and other comorbidities...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28987310/spontaneous-subclavian-artery-dissection-causing-ischemia-of-the%C3%A2-medulla-oblongata-and-cerebellum
#10
Naoto Nagino, Hiraku Funakoshi, Takashi Shiga, Kuniyasu Saigusa
BACKGROUND: Spontaneous subclavian artery dissection is a rare etiology. Spontaneous artery dissection causing brain ischemia is rare in all ischemic strokes. However, in young to middle-aged patients with brain ischemia, spontaneous carotid or vertebral artery dissection causing ischemic stroke accounts for 10-25%. CASE REPORT: A 58-year-old man with a history of hypertension presented to the Emergency Department with a sudden onset of left-arm paresthesia and numbness followed by symptoms of vertigo and vomiting...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28984522/the-v3-segment-of-the-vertebral-artery-as-a-robust-donor-for-intracranial-to-intracranial-interpositional-bypasses-technique-and-application-in-5-patients
#11
Ali Tayebi Meybodi, Arnau Benet, Michael T Lawton
The V3 segment of the vertebral artery (VA) has been studied in various clinical scenarios, such as in tumors of the craniovertebral junction and dissecting aneurysms. However, its use as a donor artery in cerebral revascularization procedures has not been extensively studied. In this report, the authors summarize their clinical experience in cerebral revascularization procedures using the V3 segment as a donor. A brief anatomical description of the relevant techniques is also provided.
October 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28967591/syringomyelia-due-to-lumbar-spinal-fluid-drainage-in-the-acute-phase-of-subarachnoid-hemorrhage-a-case-report
#12
Akira Machida, Mutsumi Fujii, Tasuku Ishihara, Eiichiro Amano, Shinichi Otsu, Shoko Fujii, Natsumi Tamada, Juri Kiyokawa, Masataka Yoshimura, Shin Hirota, Shinji Yamamoto
Lumbar spinal fluid drainage is a common procedure for treating hydrocephalus and alleviating vasospasm by egesting blood in the subarachnoid cavity after subarachnoid hemorrhage. Despite being an effective and safe procedure, cerebrospinal fluid overdrainage might result in serious complications. Here we report the case of a 49-year-old man who suffered from tonsillar herniation with subsequent cervicothoracic syringomyelia in the acute phase of subarachnoid hemorrhage due to vertebral artery dissection. About 2 weeks after lumbar drainage was switched from external ventricular drainage initiated on the day of subarachnoid hemorrhage, the recovery from the disturbance of consciousness revealed tetraplegia, and magnetic resonance imaging demonstrated tonsillar herniation and syringomyelia...
September 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28966151/the-long-and-winding-road-thoracic-myelopathy-associated-with-occipitocervical-dural-arteriovenous-fistula
#13
Angelique Sao-Mai Do, Joseph Kapurch, Ravi Kumar, John Port, Jeffrey W Miller, Jamie J Van Gompel
OBJECTIVES: Spinal dural arteriovenous fistulas (DAVFs) have diverse presentations. Magnetic resonance imaging (MRI) reveals spinal cord swelling in only 45% to 74% of cases. We present an unusual case of a 57-year old man with a craniocervical junction DAVF in which the edema appeared in the thoracolumbar region, skipping the cervical spinal cord. METHODS: A case report and literature review from a tertiary referral center are provided. RESULTS: In our patient, symptoms progressed over 3 months from low back and radicular pain to weakness, saddle anesthesia, and urinary retention...
September 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28962011/treatment-of-dissecting-distal-vertebral-artery-v4-aneurysms-with-flow-diverters
#14
Jacquelyn A Corley, Ali Zomorodi, L Fernando Gonzalez
BACKGROUND: Dissecting aneurysms of the intracranial vertebral arteries are rare; however, treatment of these presents multiple challenges, including high risk of rebleeding, development of thromboembolic strokes, and progressive partial thrombosis. Flow diverters, such as Pipeline Endovascular Devices (PEDs; Covidien, Medtronic Inc, Dublin, Ireland), have emerged as a potential treatment option. OBJECTIVE: To present our experience with patients treated at our institution with PEDs for dissecting distal vertebral artery (V4 segment) aneurysms...
August 9, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28948451/a-diagnostic-approach-to-stroke-in-young-adults
#15
REVIEW
Christopher A Stack, John W Cole
Optimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the "standard" vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask is why did this patient have a stroke? A "heart to head" diagnostic approach is recommended...
September 25, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28943421/rotational-vertebral-artery-dissection-secondary-to-anomalous-entrance-into-transverse-foramen
#16
Stephen A Johnson, Andrew F Ducruet, Jonathan B Bellotte, Charles E Romero, Robert M Friedlander
BACKGROUND: Rotational vertebral artery occlusion is a rare syndrome characterized by vertebrobasilar insufficiency secondary to position-dependent occlusion of the vertebral artery. Most cases reported in the literature have been attributed to osteophytic compression, either from the occipital condyle or within the transverse foramen. However, vertebral artery dissection secondary to motion in the setting of anomalous anatomy has not been reported. CASE DESCRIPTION: To the authors' knowledge, rotational vertebral artery occlusion and dissection secondary to anomalous entrance into the transverse foramen have never been reported...
September 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28927912/steinmann-pins-for-c1-lateral-mass-screw-placement-during-atlantoaxial-stabilization
#17
Joshua E Meyers, Kunal Vakharia, Joseph M Kowalski, Vassilios G Dimopoulos, John Pollina
OBJECTIVE: The authors describe a modified technique for placement of the C1 lateral mass screw using a Steinmann pin as a guide. This technique minimizes dissection and provides atlantoaxial stabilization during arthrodesis. METHODS: In our technique, a non-threaded 1.6mm spade-tip Steinmann pin is placed into the lateral mass of C1 to serve as a guide over which a powered drill is used for screw insertion. Perioperative data were collected for consecutive patients who underwent a C1-2 arthrodesis that involved the modified technique between March 2010 and July 2016...
September 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28922886/intracranial-bypass-of-posterior-inferior-cerebellar-artery-aneurysms-indications-technical-aspects-and-clinical-outcomes
#18
David J Bonda, Mohamad Labib, Jeffrey M Katz, Rafael A Ortiz, David Chalif, Avi Setton, David J Langer, Amir R Dehdashti
BACKGROUND: For some posterior inferior cerebellar artery (PICA) aneurysms, there is no constructive endovascular or direct surgical clipping option. Intracranial bypass is an alternative to a deconstructive technique. OBJECTIVE: To evaluate the clinical features, surgical techniques, and outcome of PICA aneurysms treated with bypass and obliteration of the diseased segment. METHODS: Retrospective review of PICA aneurysms treated via intracranial bypass was performed...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922877/use-of-a-polytetrafluoroethylene-coated-vascular-plug-for-focal-intracranial-parent-vessel-sacrifice-for-fusiform-aneurysm-treatment
#19
Andrew P Carlson, Mohammad Abbas, Patricia Hall, Christopher Taylor
BACKGROUND: Fusiform intracranial aneurysms are challenging due to the circumferential nature of the disease. Endovascular parent vessel sacrifice with coils may be a treatment option, but typically requires a long vessel segment to induce complete cessation of flow. OBJECTIVE:   We evaluate early clinical experience with the intracranial use of the microvascular plug (MVP; Medtronic, Dublin, Ireland) device and to compare to previous coil-only techniques for vertebral artery sacrifice for fusiform vertebral aneurysm...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28899830/simple-lateral-suboccipital-approach-and-modification-for-vertebral-artery-aneurysms-a-study-of-52-cases-over-10-years
#20
Mardjono Tjahjadi, Behnam Rezai-Jahromi, Joseph Serrone, Ville Nurminen, Joham Choque-Velasquez, Riku Kivisaari, Hanna Lehto, Mika Niemelä, Juha Hernesniemi
INTRODUCTION: Complex skull base approaches are frequently used to treat intracranial vertebral artery (VA) and proximal posterior inferior cerebellar artery (PICA) aneurysms. These complex procedures are associated with higher risk of neurovascular injury. Hence, a less invasive surgical approach is needed to improve treatment's efficacy and safety. MATERIAL AND METHODS: A retrospective analysis was conducted on clinical and radiological data from surgeries where simple lateral suboccipital and "lateral enough" approaches were used to clip VA aneurysms in the Department of Neurosurgery at Helsinki University Central Hospital from 2000 - 2009...
September 9, 2017: World Neurosurgery
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