Database : MEDLINE
Search on : Vertebral and Artery and Dissection [Words]
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[PMID]: 29239686
[Au] Autor:Berti AF; Zafar A; Ikram A; Calder CS; Sorte DE
[Ad] Address:1 Department of Neurology, 1104 University of New Mexico , Albuquerque, USA.
[Ti] Title:Recurrent posterior circulation infarcts secondary to vertebral artery external compression treated with endovascular deconstruction.
[So] Source:Interv Neuroradiol;24(2):178-182, 2018 Apr.
[Is] ISSN:2385-2011
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:When multiple, recurrent infarcts occur in spite of maximal medical management, the level of suspicion for atypical vascular injury should be heightened. We present a case of a patient who presented with recurrent posterior circulation infarcts despite optimized medical management. On imaging, he was found to have external anatomical vertebral artery muscular and/or osseous compression leading to repetitive vascular injury and strokes. Recurrent intimal injury and vertebral artery to intracranial emboli despite anticoagulation and subsequent dual antiplatelet therapy necessitated definitive operative management. Surgical bypass, external surgical decompression, reconstructive endovascular, and deconstructive endovascular techniques were carefully considered. A deconstructive endovascular approach was chosen as the least morbid option. The use of endovascular plugs such as a microvascular plug provides a quick and effective means of achieving a therapeutic parent artery occlusion in lieu of traditional coil occlusion. Although reserved as a last resort, parent artery occlusion can be a viable option to treat recurrent strokes, particularly in a nondominant vertebral artery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1177/1591019917747879

  2 / 2615 MEDLINE  
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[PMID]: 29489668
[Au] Autor:Yang L; Ran H
[Ad] Address:Institute of Ultrasound Imaging, Chongqing Medical University, Chongqing.
[Ti] Title:Extracranial vertebral artery dissection: Findings and advantages of ultrasonography.
[So] Source:Medicine (Baltimore);97(9):e0067, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Vertebral artery dissection (VAD) is not uncommon in the young adult population. Owing to the various clinical manifestations; the diagnosis of VAD mainly depends on imaging examinations. Ultrasound has found an increasingly wide utilization in the diagnosis of VAD because of the continuous improvement in the resolution of ultrasonic instruments and accessibility.We retrospectively collected the data of patients with a US-proven extracranial vertebral artery dissection. In accordance with the sonographic findings, all patients were classified as having intramural hematoma, double-lumen dissection, and occlusion dissection. The patients' age, sex, risk factors for cerebrovascular diseases, and sonographic characteristics were analyzed.A total of 37 cases of US-proven extracranial vertebral artery dissections were included in this study. Thirty patients presented with intramural hematoma dissection, 1 had double-lumen dissection and 6 had occlusion dissection. No dissecting aneurysm was found in any of the patients. Concerning a subsequent angiographic examination, 13 patients failed to undergo the examination for various reasons. The remaining 24 patients underwent digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and computerized tomographic angiography (CTA), among whom 1 patient with intramural hematoma was underdiagnosed because the DSA result was interpreted as normal. One patient who underwent CTA had a contrast allergy. In the remaining patients, the results of other imaging examinations were consistent with the US results.Intramural hematoma dissection is the most common type of extracranial vertebral artery dissection. Over other angiographic examinations US has a big diagnostic advantage for its direct view, accuracy, and low cost.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Process
[do] DOI:10.1097/MD.0000000000010067

  3 / 2615 MEDLINE  
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[PMID]: 29479922
[Au] Autor:Lovrencic-Huzjan A; Bosnar-Puretic M; Vukovic-Cvetkovic V; Basic Kes V
[Ad] Address:Clinical Department of Neurology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
[Ti] Title:Bilateral Vertebral Artery Dissection - Multiple Artery Affection or Early Recurrence?
[So] Source:Acta Clin Croat;56(3):550-554, 2017 Sep.
[Is] ISSN:0353-9466
[Cp] Country of publication:Croatia
[La] Language:eng
[Ab] Abstract:In a certain percentage of patients with craniocervical artery dissection, dissections affect multiple arteries. Some investigators consider that the dissections diagnosed as multiple might have occurred sequentially within a short time frame. We describe an oligosymptomatic patient with bilateral progressive vertebral artery dissection. Careful history taking added new data on transient left arm weakens two months earlier, as a possibility of the earlier disease onset.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Process
[do] DOI:10.20471/acc.2017.56.03.23

  4 / 2615 MEDLINE  
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[PMID]: 29477700
[Au] Autor:Campero A; Villalonga JF; Elizalde RL; Ajler P
[Ad] Address:Department of Neurological Surgery, Hospital Padilla, Tucumán, Argentina; School of Medicine, National University of Tucumán, Tucumán, Argentina. Electronic address: alvarocampero@yahoo.com.
[Ti] Title:The nuchal lines as anatomical landmarks to dissect the muscles in the far-lateral approach.
[So] Source:World Neurosurg;, 2018 Feb 22.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: A critical step in the far lateral approach (FLA) is the exposure of V3 segment of the vertebral artery (VA), located in the depth of the suboccipital triangle (SOT). A safe exposure of the SOT is achieved by means of a plane-by-plane dissection, which carries the risk of devascularization. A suitable alternative is to lift a cutaneous muscle flap including the 3 first muscle planes, and leave the deepest plane (SOT) attached to the skull base. To achieve this, it is necessary to have superficial anatomic repairs to help us identify our cleavage site.Our objective is to describe the use of the nuchal lines as a safe, effective and reproducible method to dissect the muscles in order to expose the SOT and VA. METHODS: Eight adult cadaveric heads, fixed with formaldehyde and injected, were studied. On both sides, an FLA was simulated by using the nuchal lines as anatomic repairs to expose the SOT. This technique was later applied on 10 patients requiring a FLA. RESULTS: The anatomic dissections performed confirmed the identification, by means of the nuchal lines, of a cleavage site, which made it possible to separate the deepest muscle plane from the rest of the flap. This technique was successfully applied on the 10 operated patients. CONCLUSION: The nuchal lines allow to dissect the muscles in 2 groups, one superficial, and the other deep (SOT), that remains attached to the skull base. Thus, the V3 segment of the VA is easily exposed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:Publisher

  5 / 2615 MEDLINE  
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[PMID]: 29262388
[Au] Autor:Takahara K; Amano T; Tsurusaki Y; Koga N; Murao K; Arihiro S; Yamaguchi S; Haga S
[Ad] Address:Department of Neurosurgery, Kyushu Rosai Hospital.
[Ti] Title:[Ruptured Dissecting Aneurysm of the Fenestrated Vertebral Artery:A Case Report].
[So] Source:No Shinkei Geka;45(12):1075-1080, 2017 Dec.
[Is] ISSN:0301-2603
[Cp] Country of publication:Japan
[La] Language:jpn
[Ab] Abstract:Fenestration of a vertebral artery(VA)is a rare anomaly that has occasionally been associated with the formation of saccular aneurysms, whereas dissection of a limb of the fenestrated artery is an extremely rare occurrence. We report the case of a ruptured dissecting aneurysm of a fenestrated VA. A 56-year-old man presented with acute-onset headache followed by respiratory failure. Computed tomography(CT)revealed diffuse subarachnoid hemorrhage, and CT angiography(CTA)demonstrated fenestration of the left VA and a fusiform aneurysm of the dorsolateral limb of the fenestrated VA. CT after injection of contrast medium revealed dissection of a limb of the fenestrated VA. A comparison of the 3-dimensional digital subtraction angiogram obtained 2 days later with the initial CTA showed that the dissecting aneurysm had shrunk. Coil embolization of the dissecting limb of the fenestrated VA was achieved, and the patient was discharged without neurologic deficit. Further advancements in neuroimaging modalities will provide more opportunities to treat dissecting aneurysms of fenestrated VAs. The relevant clinical characteristics of VA fenestration and the treatment options for a dissecting aneurysm of a limb of the fenestrated VA are also discussed in this report.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:In-Process
[do] DOI:10.11477/mf.1436203650

  6 / 2615 MEDLINE  
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[PMID]: 29449518
[Au] Autor:Kawaguchi M; Nii K; Sakamoto K; Kawahara K; Inoue R; Hiraoka F; Morinaga Y; Mitsutake T; Hanada H; Tsutsumi M
[Ad] Address:Department of Neurosurgery, Fukuoka University Chikushi Hospital.
[Ti] Title:[The Efficacy of Percutaneous Transluminal Angioplasty and Stenting for Traumatic Vertebral Artery Dissection due to Cervical Vertebral Fracture].
[So] Source:No Shinkei Geka;46(2):133-138, 2018 Feb.
[Is] ISSN:0301-2603
[Cp] Country of publication:Japan
[La] Language:jpn
[Ab] Abstract:A 73-year-old man was admitted at another hospital after a traffic accident. The diagnosis was cervical vertebral fracture. Despite conservative treatment, 5 days later he manifested dysarthria due to cerebellar infarction and was transferred to our hospital. Imaging studies revealed right vertebral arterial dissection at the level of the axial fracture. We performed percutaneous transluminal angioplasty with stenting to address his subacute vertebral artery dissection prior to treating the cervical vertebral fracture using external fixation. His clinical course was good;ischemia did not recur after stenting and his dysarthria disappeared upon rehabilitation. Cerebral angiograms obtained 6 months later revealed no significant in-stent restenosis. While medical management tends to be the first-line treatment of traumatic vertebral artery dissection, percutaneous transluminal angioplasty with stenting is necessary before treating other traumatic lesions to prevent neurologic events.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Data-Review
[do] DOI:10.11477/mf.1436203689

  7 / 2615 MEDLINE  
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[PMID]: 29314801
[Au] Autor:Popovic R; Radovinovic-Tasic S; Rusovic S; Lepic T; Ilic R; Raicevic R; Obradovic D
[Ti] Title:Urgent carotid stenting before cardiac surgery in a young male patient with acute ischemic stroke caused by aortic and carotid dissection.
[So] Source:Vojnosanit Pregl;73(7):674-8, 2016 Jul.
[Is] ISSN:0042-8450
[Cp] Country of publication:Serbia
[La] Language:eng
[Ab] Abstract:Introduction: Acute aortic dissection (AD) is the most common life-threatening disorder affecting the aorta. Neurological symptoms are present in 17-40% of cases. The management of these patients is controversial. Case report: We presented a 37-year-old man admitted for complaining of left-sided weak-ness. Symptoms appeared two hours before admission. The patient had no headache, neither thoracic pain. Neurological examination showed mild confusion, left-sided hemiplegia, National Institutes of Health Stroke Scale (NIHSS) score was 10. Ischemic stroke was suspected, brain multislice computed tomography (MSCT) and angiography were performed and right intrapetrous internal carotid artery dissection noted. Subsequent color Doppler ultrasound of the carotid arteries showed dissection of the right common carotid artery (CCA). The patient underwent thoracic and abdominal MSCT aortography which showed ascending aortic dissection from the aortic root, propagating in the brachiocephalic artery and the right CCA. Digital subtraction angiography was performed subsequently and two stents were successfully implanted in the brachiocephalic artery and the right CCA prior to cardiac surgery, only 6 hours after admission. The ascending aorta was reconstructed with graft interposition and the aortic valve re-suspended. The patient was hemodynamically stable and with no neurologic deficit after surgery. Unfortinately, at the operative day 6, mediastinitis developed and after intensive treatment the patients died 35 days after admission. Conclusion: In young patients with suspected stroke and oscillatory neurological impairment urgent MSCT angiography of the brain and neck and/or Doppler sonography of the carotid and vertebral artery are mandatory to exclude carotid and aortic dissection. The prompt diagnosis permits urgent carotid stenting and cardiosurgery. To the best of our knowledge, this is the first published case of immediate carotid stenting in acute ischemic stroke after the diagnosis of carotid and aortic dissection and prior to cardiac surgery
[Mh] MeSH terms primary: Aneurysm, Dissecting/surgery
Aortic Aneurysm/surgery
Brain Ischemia/etiology
Carotid Artery Diseases/surgery
Carotid Artery, Common/surgery
Stents
[Mh] MeSH terms secundary: Adult
Aneurysm, Dissecting/complications
Aneurysm, Dissecting/diagnostic imaging
Aortic Aneurysm/complications
Aortic Aneurysm/diagnostic imaging
Carotid Artery Diseases/complications
Carotid Artery Diseases/diagnostic imaging
Carotid Artery, Common/diagnostic imaging
Computed Tomography Angiography
Humans
Male
Multidetector Computed Tomography
Ultrasonography, Doppler, Color
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[Js] Journal subset:IM
[Da] Date of entry for processing:180110
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150402091P

  8 / 2615 MEDLINE  
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[PMID]: 29433365
[Au] Autor:Urasyanandana K; Songsang D; Aurboonyawat T; Chankaew E; Withayasuk P; Churojana A
[Ad] Address:1 Department of Surgery, 37680 Phramongkutklao Hospital , Phramongkutklao College of Medicine, Bangkok, Thailand.
[Ti] Title:Treatment outcomes in cerebral artery dissection and literature review.
[So] Source:Interv Neuroradiol;:1591019918755692, 2018 Jan 01.
[Is] ISSN:2385-2011
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Methods Patients with cerebral artery dissections were reviewed in a hospital setting from 2008 to 2015. Clinical presentations, lesion locations, treatment modalities, functional outcomes, and mortality were reviewed. Parent artery occlusion was the first choice for surgery or endovascular treatment of a hemorrhagic dissecting cerebral artery. Endovascular or surgical reconstructive treatment was indicated in patients whose parent artery could not be occluded. Favorable functional outcomes were determined using modified Rankin Scale (mRS) scores of 0-2. Results In total, 61 patients with cerebral artery dissections were admitted to the hospital. Seven (11.5%) had traumatic dissections. All traumatic dissections were located in the internal carotid arteries. Overall favorable outcome rate was about 57% (4/7). Spontaneous cerebral artery dissections were found in 54 patients. No difference in favorable outcomes was observed between parent vessel occlusion and selective occlusion with parent vessel preservation (or vessel reconstruction) (70% and 63%, respectively, p = 1.000). Patients who presented with spontaneous dissection without intracranial hemorrhage had more favorable outcomes than those with intracranial hemorrhage (79% and 52%, respectively, p = 0.045). The mortality rate of patients with spontaneous dissection was 7.4%. Conclusions Most of the traumatic dissections were located on the internal carotid arteries and spontaneous dissections were commonly located on vertebral arteries. Nonhemorrhagic spontaneous cerebral dissections had better functional outcomes after treatment. Endovascular and surgical management were effective treatments by parent vessel occlusion or reconstructions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:Publisher
[do] DOI:10.1177/1591019918755692

  9 / 2615 MEDLINE  
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[PMID]: 29433176
[Au] Autor:Sanchis-Gimeno JA; Llido S; Miquel-Feutch M; Quiles-Guinau L; Rios L; Murillo-Llorente M; Perez-Bermejo M; Nalla S
[Ad] Address:Department of Anatomy and Human Embryology, University of Valencia, Faculty of Medicine, Valencia, Spain. Electronic address: juan.sanchis@uv.es.
[Ti] Title:The Decreasing Prevalence of the Arcuate Foramen.
[So] Source:World Neurosurg;110:521-525, 2018 Feb.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The arcuate foramen (AF), or ponticulus posticus, is an anatomic variant of the first cervical vertebra that consists of a complete or partial osseous bridge over the groove for the vertebral artery and extends from the posterior aspect of the superior articular facet to the superior lateral border of the posterior arch. The AF has been associated with clinical symptoms, such as headache, migraine, neck pain, shoulder pain, arm pain, and vertebral artery dissection. We aimed to test whether the prevalence of the AF has decreased in the modern human population over the past centuries as a result of reduction in inbreeding and endogamy. METHODS: Possible reduction in the prevalence of the AF was assessed by comparing a 17th century rural sample (n = 108) with a 20th century modern urban sample (n = 192). RESULTS: When comparing the 17th and the 20th century samples, we found a statistically significant (P = 0.003) reduction of 14.5% (95% confidence interval 4.5-24.5) in the prevalence of the AF. CONCLUSIONS: Prevalence of the AF has been decreasing over the past centuries.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Data-Review

  10 / 2615 MEDLINE  
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[PMID]: 29415135
[Au] Autor:Dunay SN; Perreault MD; Grubish LK
[Ad] Address:Madigan Army Medical Center, Joint Base Lewis-McChord, 9040 Jackson Avenue, Tacoma, WA 98430.
[Ti] Title:A Case of Delayed Traumatic Vertebral Artery Dissection.
[So] Source:Mil Med;, 2018 Feb 05.
[Is] ISSN:1930-613X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Vertebral artery dissection is of special clinical importance because of its often-delayed presentation and the risk of potentially permanent neurological deficit, or even death, as a result of injury. Once a rarely discovered injury, the better availability and use of computed tomography and magnetic resonance imaging have contributed to an increased incidence. Early diagnosis and treatment can almost eliminate the threat of acute cerebral vascular injury and save lives. In this report, we review a case of delayed traumatic vertebral artery dissection and discuss the key clinical findings and management strategies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180207
[Lr] Last revision date:180207
[St] Status:Publisher
[do] DOI:10.1093/milmed/usx096


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