scholarly journals P.105 Missed vertebral artery dissection: a case series

2018 ◽  
Vol 45 (s2) ◽  
pp. S44-S44
Author(s):  
A Persad ◽  
B Stewart
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Case Series ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Minor Trauma ◽  
Posterior Circulation Stroke ◽  
Acute Infarction ◽  
History Of ◽  
Neck Manipulation

Background: Vertebral artery dissections are the second most common cause of posterior circulation stroke. Particularly in young people, they must be considered as causes of acute infarction, especially with a history of cervical trauma. Here, we present three cases of vertebral artery dissection that were initially not diagnosed as such. All were caused by uncommon mechanisms; one by self-inflicted neck manipulation, and one as a sequela of falling from a trampoline, and one from minor trauma to the head while standing. Methods: This is a series of three cases seen by the authors of posterior circulation stroke secondary to vertebral artery dissection caused by uncommon mechanisms. Results: N/A Conclusions: Vertebral artery dissection should be considered as a differential diagnosis in patients presenting with acute head and/or neck pain and any neurological findings in relation to acute neck trauma.

scholarly journals Combined thrombolysis in posterior circulation stroke caused by bilateral vertebral artery dissection in squash player

2014 ◽  
Vol 48 (4) ◽  
pp. 299-304 ◽  
Author(s):  
Emilia Frankowska ◽  
Krzysztof Brzozowski ◽  
Jacek Staszewski ◽  
Norbert Kolmaga ◽  
Adam Stępień ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Posterior Circulation Stroke

scholarly journals Bilateral vertebral artery dissection complicated by posterior circulation stroke in a young man

Medicine ◽  
2020 ◽  
Vol 99 (44) ◽  
pp. e22822
Author(s):  
Zhichao Li ◽  
Junni Liu ◽  
Xiang Wang ◽  
Xiaohui Liu ◽  
Qinjian Sun ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Posterior Circulation Stroke

Vertebral artery dissection and stroke following neck manipulation by Native American healer

Neurology ◽  
2002 ◽  
Vol 58 (9) ◽  
pp. 1434-1434 ◽  
Author(s):  
J. G. Quintana ◽  
E. C. Drew ◽  
T. E. Richtsmeier ◽  
L. E. Davis
Keyword(s):  
Native American ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Neck Manipulation

scholarly journals A Vertebral Artery Dissection with Basilar Artery Occlusion in a Child

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Katleen Devue ◽  
Annemie Van Ingelgem ◽  
Katrien De Keukeleire ◽  
Marc De Leeuw
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Vertebral Artery Dissection ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Left Vertebral Artery ◽  
Artery Dissection ◽  
Minor Trauma ◽  
Systemic Thrombolysis ◽  
The Right

This paper presents the case report of an 11-year-old boy with an acute dissection with thrombosis of the left vertebral artery and thrombosis of the basilar artery. The patient was treated with acute systemic thrombolysis, followed by intra-arterial thrombolysis, without any clinical improvement, showing left hemiplegia, bilateral clonus, hyperreflexia, and impaired consciousness. MRI indicated persistent thrombosis of the arteria basilaris with edema and ischemia of the right brainstem. Heparinization for 72 hours, followed by a two-week LMWH treatment and subsequent oral warfarin therapy, resulted in a lasting improvement of the symptoms. Vertebral artery dissection after minor trauma is rare in children. While acute basilar artery occlusion as a complication is even more infrequent, it is potentially fatal, which means that prompt diagnosis and treatment are imperative. The lack of class I recommendation guidelines for children regarding treatment of vertebral artery dissection and basilar artery occlusion means that initial and follow-up management both require a multidisciplinary approach to coordinate emergency, critical care, interventional radiology, and child neurology services.

Abstract TP84: Prognostic Factor of Intracranial Vertebral Artery Dissection: High Resolution Vessel Wall Magnetic Resonance Imaging Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jae-Hwan Kim ◽  
Hyung Jun Kim ◽  
Ye Sel Kim ◽  
Woo-Keun Seo ◽  
Oh Young Bang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
High Resolution ◽  
Prognostic Factor ◽  
Vertebral Artery ◽  
Vessel Wall ◽  
Independent Predictor ◽  
Vertebral Artery Dissection ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Poor Outcomes

Background: Vertebral artery dissection (VAD) is well recognized cause of stroke in young and middle aged individuals. But, prognostic factor of posterior circulation ischemic stroke or transient ischemic attack (TIA) caused by intracranial VAD has been rarely discussed. Our aim was to evaluate the predictors of poor outcomes in posterior circulation ischemic stroke caused by intracranial VAD. Methods: We retrospectively reviewed patients with posterior circulation ischemic stroke or TIA caused by intracranial VAD using high-resolution vessel wall MRI who were recruited from Samsung Medical Center Stroke Registry (between January 1, 2011 and April 30, 2019). Poor outcomes were defined as a 3-months modified Rankin scale (mRS) score ≥ 2. Results: We registered 96 patients (74 males; mean age, 58.9±14.2 years) with acute posterior circulation ischemic stroke or TIA caused by intracranial VAD. Trauma history associated with VAD was presented in 23 (24%) of patients. Headache and neck pain around neurological symptom onset were presented in 41 (42.7%) and 19 (19.8%) of patients, respectively. Dissecting aneurysm, bilateral vertebral artery involvement, basilar artery involvement and wall hematoma with dissection were presented in 26 (27.1%), 26 (27.1%), 12 (12.5%) and 66 (68.8%) of patients, respectively. Of the 96 VADs, 26 (27.1%) presented with focal stenosis, 21 (21.9%) with multifocal stenosis, and 57 (59.4%) with occlusion. Lateral medulla involvement and multiple territory involvement were presented in 35 (36.5%) and 31 (32.3%) of patients. Recurrence rate of ischemic stroke or TIA within 90 days of symptom onset was 6.25%. Twenty-nine patients (30.2%) had poor outcomes at 3 months. Lateral medulla involvement was an independent predictor for poor outcome (odds ratio=3.293, 95% confidence interval=1.301-8.333, p=0.012). Conclusion: Posterior circulation ischemic stroke or TIA caused by intracranial VAD is associated with relatively benign clinical course. But the presence of lateral medulla involvement is independent predictor for poor outcome. Patients presenting lateral medullary infarction caused by intracranial VAD should be monitored closely.

scholarly journals Diagnosis of vertebral artery dissection in childhood posterior circulation arterial ischaemic stroke

2015 ◽  
Vol 58 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Nadine McCrea ◽  
Dawn Saunders ◽  
Emmanouil Bagkeris ◽  
Manali Chitre ◽  
Vijeya Ganesan
Keyword(s):  
Ischaemic Stroke ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Posterior Circulation ◽  
Artery Dissection ◽  
Arterial Ischaemic Stroke

scholarly journals Minor Trauma Causing Stroke in a Young Athlete

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Vineet Gupta ◽  
Naveen Dhawan ◽  
Jaya Bahl
Keyword(s):  
Differential Diagnosis ◽  
Vertebral Artery ◽  
Treatment Modality ◽  
Vertebral Artery Dissection ◽  
Young Athlete ◽  
Left Vertebral Artery ◽  
Artery Dissection ◽  
Minor Trauma ◽  
The Third ◽  
Ct Angiogram

A 17-year-old Caucasian male presented with sudden dizziness, ataxia, vertigo, and clumsiness lasting for a couple of hours. He had a subtle trauma during a wrestling match 2 days prior to the presentation. A CT Angiogram (CTA) and MRI showed left vertebral artery dissection (VAD). The patient was treated with anticoagulation with heparin drip in the ICU. The patient was discharged home on the third day on Lovenox-warfarin bridging. This case underscores the importance of considering VAD as a differential diagnosis in patients with sports-related symptoms especially in activities entailing hyperextension or hyperrotation of neck. Due to a varied latent period, often minor underlying trauma, and subtle presentation, a low index of suspicion is warranted in timely diagnosis and treatment of VAD. Considering recent evidence in treatment modality, either antiplatelet therapy or anticoagulation may be used for treatment of VAD.

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