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vertebral artery dissection

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https://www.readbyqxmd.com/read/29790968/-macrovascular-decompression-of-dolichoectatic-vertebral-artery-causing-hemifacial-spasm-using-goretex-sling-2-dimensional-operative-video
#1
Stephan A Munich, Jacques J Morcos
Hemifacial spasm is characterized by painless and involuntary spasms of the muscles supplied by the facial nerve, most commonly involving the orbicularis oculi. The most common cause of hemifacial spasm is compression of the facial nerve's root by the anterior inferior, or posterior inferior, cerebellar arteries (AICA or PICA). However, in <1% of cases, the compression can be due to a dolichoectatic vertebral artery. Microvascular decompression using Teflon patties may be sufficient when the offending artery is small (eg, AICA or PICA)...
May 22, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29775770/treatment-of-ruptured-vertebral-artery-dissection-and-abdominal-hemorrhage-associated-with-segmental-arterial-mediolysis-using-endovascular-coil-embolization-va-dissection-associated-with-sam
#2
Taiki Isaji, Tomotaka Ohshima, Sigeru Miyachi, Naoki Matsuo, Reo Kawaguchi, Masakazu Takayasu
BACKGROUND: Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. CASE DESCRIPTION: A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29770500/variable-anatomic-configuration-of-the-posterior-spinal-arteries-in-humans
#3
Santiago Rojas, Marisa Ortega, Alfonso Rodríguez-Baeza
INTRODUCTION: Posterior spinal arteries (PSAs) arise from the vertebral (VA) or posterior inferior cerebellar (PICA) artery. We identified variations in their origins and their anastomosis with the first posterior radiculomedullary branches in human spinal cords. MATERIALS AND METHODS: Spinal cords from male and female cadavers (n = 30) were injected with colored latex through the vertebral, ascending cervical, costocervical trunk and segmental arteries. Specimens were fixed in formalin and the spinal arteries were dissected under a surgical microscope...
May 17, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29758373/ruptured-vertebral-artery-dissecting-aneurysm-as-a-risk-factor-for-ocular-symptoms-accompanied-with-subarachnoid-hemorrhage
#4
Yosuke Moteki, Yasunari Niimi, Yoshikazu Okada, Takakazu Kawamata
OBJECTIVE: Although ruptured vertebral artery dissecting aneurysms (VADAs) are often associated with ocular symptoms, such as abducent nerve palsy and Terson's syndrome (TS), their frequency and risk factors in comparison with those associated with ruptured aneurysms in other locations have not been reported. METHODS: A total of 343 patients with non-traumatic subarachnoid hemorrhage were treated in our hospital from April 2002 to May 2016, among which 35 (10.2%) had VADA as the origin of hemorrhage...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29755236/posterior-identification-and-exposure-of-the-v3-segment-of-the-vertebral-artery
#5
Ali Nourbakhsh, Nicholas W Wiegers, Francis H Shen
Objective: The purpose of this study was to define the anatomy of the V3 segment of the vertebral artery (VA) from the posterior approach. Methods: Ten formalin-fixed cadavers were carefully dissected bilaterally using landmark features to identify and safely expose the VA from the posterior. Measurements regarding morphometric characteristics of landmark features and feasible resection quantifications were obtained and analyzed. The C2 pars was resected completely in all cadavers, averaging 15...
January 2018: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29740736/a-rare-case-of-life-threatening-traumatic-carotid-artery-dissection-in-a-child
#6
Fulya Kamit Can, Soysal Turhan, Ayse Berna Anil, Kadir Burhan Karadem, Onur Aras Isik
Penetrating injuries of the carotid and vertebral arteries are rare, but life-threatening conditions. There are still challenges in the first intervention management and patient treatment. Deciding which methods to apply in the first intervention, whether to perform imaging, and the preferred appropriate treatment for the patient (open surgery or endovascular intervention) plays a main role in the patient's survival without neurological deficit. The general management of trauma in penetrating neck injuries and the knowledge of special approaches to carotid artery injury are important for pediatric trauma centers...
May 8, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29737380/the-zonal-pattern-of-arterial-supply-to-the-brachial-plexus-and-its-clinical-significance
#7
An-Bo Gao, Yun-Cheng Lv, Ai-Ping Wang, Li-Yuan Zhong, Mao-Lin Tang, Binu-Prathap Thomas, Tian-Hong Peng
PURPOSE: To provide the anatomical basis of blood supply of brachial plexus for the clinical microsurgical treatment of brachial plexus injury. METHODS: Thirteen adult anticorrosive cadaveric specimens (8 males, 5 females) were dissected in this study. 3 fresh cases (2 males, 1 female) were used to observe the zonal pattern of arteries supplying brachial plexus, and 10 cases (6 males, 4 females) were used to observe the source and distribution of the brachial plexus arteries under microscope...
May 8, 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29725567/one-stage-stent-assisted-coil-embolization-for-rupture-side-unknown-bilateral-vertebral-artery-dissecting-aneurysms-in-an-acute-stage-a-case-report
#8
Mio Terashima, Yoichi Miura, Fujimaro Ishida, Naoki Toma, Tomohiro Araki, Shinichi Shimosaka, Kenji Kanamaru, Hidenori Suzuki
Bilateral vertebral artery dissecting aneurysms (VADAs) with subarachnoid hemorrhage (SAH) are rare and their management is still challenging. In this report, we successfully performed one-stage stent-assisted coil embolization (SAC) for bilateral VADAs with SAH in an acute stage, because the ruptured side could not be diagnosed. A 47-year-old woman presented with a sudden onset of headache without laterality, and left-side dominant SAH with bilateral VADAs was noted on computed tomography (CT) scans. The size of aneurysmal dome and neck was similar between the two VADAs, and a bleb was observed only on the right VADA...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29721341/bilateral-carotid-and-vertebral-artery-dissection-from-blunt-trauma
#9
Catherine Coss, Jeffrey Jones
Carotid and vertebral artery injuries are rare following blunt trauma. They can, however, lead to severe consequences with a significant associated rate of stroke and intracranial hemorrhage, particularly if the diagnosis and treatment are delayed. We report a case of a 23-year-old female who presented to the Emergency Department with bilateral carotid and vertebral artery dissection following a motor vehicle collision (MVC).
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29718002/vertebral-artery-dissection-masquerading-as-concussion-in-an-adolescent
#10
Gogi Kumar, Bryan Ludwig, Vipul V Patel
OBJECTIVE: Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke. METHODS: Review of the chart, peer review/discussion, and imaging interpretation. RESULTS: A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29709948/sequential-symptomatic-arterial-dissections-in-multiple-vascular-beds-in-a-patient-with-fibromuscular-dysplasia
#11
Yuki Sakamoto, Ryo Hiruta, Ayako Iijima, Yuya Sakuma, Yutaka Konno
A 60-year-old man was admitted to our hospital because of abdominal pain and disturbed consciousness. Head magnetic resonance imaging showed right vertebral artery dissection and abdominal enhanced computed tomography showed dissection of the superior mesenteric artery. The patient was diagnosed as having fibromuscular dysplasia (FMD) based on conventional angiography. Although multiple vascular bed involvement is observed in approximately 40% of FMD patients, reports of sequential symptomatic dissections in various vascular beds are rare...
April 27, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29707096/dissecting-vertebral-artery-aneurysm-presenting-regrowth-after-stent-assisted-coil-embolization-in-acute-stage
#12
Takamichi Hijikata, Eiichi Baba, Kazutaka Shirokane, Atsushi Tsuchiya, Motohiro Nomura
For a case of dissecting vertebral artery aneurysm (DVAA) in a dominant vertebral artery (VA) or posterior inferior cerebellar artery (PICA)-involving lesion, stent-assisted coil embolization (SACE) is an effective technique to preserve blood flow of the VA. A 41-year-old man presented with subarachnoid hemorrhage. Angiography demonstrated DVAA on the left VA just distal to the PICA, and the right VA was thinner than the left. For this case, SACE was performed to preserve the left VA and PICA. On the 10th day, angiography showed recurrence of the dissection...
June 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29701850/safeguarding-the-anomalous-vertebral-artery-while-dissecting-drilling-and-instrumentation-of-c1-2-joint-for-congenital-atlantoaxial-dislocation-2-dimensional-operative-video
#13
Pravin Salunke, Sushanta K Sahoo
The pathology in congenital atlantoaxial instability is usually in C1-2 joints. Addressing the joints appears to be the most rationale approach. The joints are usually approached posteriorly, manipulated, and fused. Understanding the normal and abnormal anatomy is important. Normally, the third segment of the vertebral artery courses lateral to the C1-2 joint. However, in about 20% of the cases with complex congenital craniovertberal junction anomalies the artery crosses the joint posteriorly. The artery in such cases may be injured while joint manipulation and instrumentation with disastrous consequences...
April 26, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29701566/the-subatlantic-triangle-gateway-to-early-localization-of-the-atlantoaxial-vertebral-artery
#14
Ali Tayebi Meybodi, Sirin Gandhi, Mark C Preul, Michael T Lawton
OBJECTIVE Exposure of the vertebral artery (VA) between C-1 and C-2 vertebrae (atlantoaxial VA) may be necessary in a variety of pathologies of the craniovertebral junction. Current methods to expose this segment of the VA entail sharp dissection of muscles close to the internal jugular vein and the spinal accessory nerve. The present study assesses the technique of exposing the atlantoaxial VA through a newly defined muscular triangle at the craniovertebral junction. METHODS Five cadaveric heads were prepared for surgical simulation in prone position, turned 30°-45° toward the side of exposure...
April 27, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29696529/utility-of-the-variable-flip-angle-3d-fast-spin-echo-isofse-sequence-on-3t-mr-for-diagnosing-vertebrobasilar-artery-dissection
#15
Masaki Ogawa, Shingo Omata, Hirohito Kan, Nobuyuki Arai, Marehiko Asai, Misugi Urano, Yuta Shibamoto
We aimed to investigate the utility of the isoFSE sequence, one of the variable flip angle 3D fast-spin echo sequences, on 3T-MR for displaying vessel walls and diagnosing vertebrobasilar artery dissection (VAD). We retrospectively evaluated 12 initial and 28 follow-up images from 12 patients diagnosed with either intracranial VAD or carotid artery dissection. The image quality for displaying the vessel wall was scored using a five-point scale (1 poor, 5 excellent) on initial T1-weighted isoFSE images for each region of the arteries...
April 25, 2018: Radiological Physics and Technology
https://www.readbyqxmd.com/read/29686917/a-recurrent-cervical-neurenteric-cyst-treated-anteriorly-safe-gross-total-excision-facilitated-by-prophylactic-unilateral-vertebral-artery-exposure-microdissection-and-spinal-cord-monitoring-a-case-report-and-technical-note
#16
Kazunobu Kida, Toshikazu Tani, Tateo Kawazoe, Makoto Hiroi
This study reports on a 67-year-old woman with partial Brown-Séquard syndrome due to a recurrent cervical neurenteric cyst at C3 to C4. The myelopathic symptoms reappeared 22 years after a previous shunting operation performed posteriorly with a silicone tube connecting the intradural cervical cyst cavity to the subarachnoid space. We have now succeeded in removing the cyst nearly completely with the anterior approach. The surgical procedure consisted of right vertebral artery exposure at C3 and C4 and a subtotal corpectomy of C3 followed by microdissection of the cyst, duraplasty, and iliac strut graft fusion...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29686162/-characteristics-of-headache-and-neck-pain-in-spontaneous-vertebral-artery-dissections
#17
Emiko Hori, Satoshi Hori, Soshi Okamoto, Takashi Shibata, Kimiko Oya Umemura, Michiya Kubo, Eisuke Furui, Yukio Horie, Satoshi Kuroda
PURPOSE: Sudden onset severe occipital/nuchal pain is believed to be a typical symptom of vertebral artery dissection(VAD). However, recent developments in diagnostic imaging have suggested that VAD is not always associated with such pain. This study aimed to analyze the clinical features of initial symptoms in patients with VAD. METHODS: In total, this study included 29 consecutive patients who were referred to our hospital because of only headache and/or nuchal pain due to VAD between 2011 and 2016...
April 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29653277/a-crick-in-the-neck-followed-by-massage-offered-him-a-stroke-an-uncommon-case-of-vertebral-artery-dissection
#18
Gautam Dutta, Anita Jagetia, Arvind K Srivastava, Daljit Singh, Hukum Singh, Ravindra K Saran
We present an unusual case of vertebral artery dissection in a 30-year-old male patient following an episode of neck massage. He developed headache, nausea, vomiting, blurred vision, diplopia, dizziness, and ataxia following the procedure. We also discuss a review of the pathology, diagnosis, symptomatology, treatment, prognosis, and occurrence of this rare entity.
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29628950/safety-assessment-of-endovascular-treatment-of-cerebral-aneurysms-in-patients-with-fibromuscular-dysplasia
#19
Matthew T Bender, Christopher Hurtado, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Li-Mei Lin, Alexander L Coon, Geoffrey P Colby
Background: The prevalence of cerebral aneurysms is increased in fibromuscular dysplasia (FMD). The presence of FMD may serve as discouragement to elective endovascular aneurysm treatment. Outcomes of endovascular intervention for aneurysms through vessels affected by FMD have not been reported. Methods: A prospectively maintained database of patients undergoing intracranial embolization was reviewed for patients with FMD who underwent endovascular aneurysm treatment...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29617905/microvascular-decompression-of-facial-nerve-and-pexy-of-the-left-vertebral-artery-for-left-hemifacial-spasm-3-dimensional-operative-video
#20
Chun-Yu Cheng, Rakshith Shetty, Vicente Martinez, Laligam N Sekhar
A 73-yr-old man presented with intractable left hemifacial spasm of 4 yr duration. Brain magnetic resonance imaging showed significant compression of left facial nerve by the left vertebral artery (VA) and anterior inferior cerebellar artery (AICA).The patient underwent a left retrosigmoid craniotomy and a microvascular decompression of the cranial nerve (CN) VII. Intraoperatively, we found that the distal AICA had a protracted subarcuate extradural course.1 This was relieved by intra/extradural dissection...
March 29, 2018: Operative Neurosurgery (Hagerstown, Md.)
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