Antiplatelet Therapy vs Anticoagulation Therapy in Cervical Artery Dissection: The Cervical Artery Dissection in Stroke Study (CADISS) Randomized Clinical Trial Final Results.

Markus, Hugh S.; Levi, CR; King, A. J.; Madigan, Jeremy; Norris, J. W.

doi:10.1016/j.jvs.2019.09.003

Cited by 50 publications

(96 citation statements)

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“…It is already established that aspirin 81-325 milligrams (mg) or clopidrogel 75 mg daily is bio-equivalent to oral anti-coagulation with warfarin for stable vertebral and carotid arterial dissections with respect to angiographic resolution and prevention of ischemic events [ 10 , 11 , 12 , 13 ]. A brief outline of these studies with the main outcomes is illustrated in Table 2 .…”

Section: Discussionmentioning

confidence: 99%

Isolated Palsy of the Cisternal Segment of the Hypoglossal Nerve Due to Arterial Dissection of the V4 Segment of the Vertebral Artery: A Case Report With a Side Note on Nerve Trunk Ischemia

Kesserwani¹

2020

Cureus

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We describe the case of a 57-year-old woman who developed severe left-sided neck pain followed by difficulty chewing, oropharyngeal dysphagia, and dysarthria. Clinically, she developed an isolated left-sided deviation of the tongue with protrusion; an isolated cisternal hypoglossal nerve palsy. A magnetic resonance angiogram imaging study revealed a left V4 cisternal vertebral artery dissection with normal diffusion-weighted imaging of the lower medulla. We outline the anatomy, histology, and pathophysiology of ischemic injury of nerve trunks and briefly review the recent trials of vertebral and carotid artery dissections.

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Section: Discussionmentioning

confidence: 99%

Isolated Palsy of the Cisternal Segment of the Hypoglossal Nerve Due to Arterial Dissection of the V4 Segment of the Vertebral Artery: A Case Report With a Side Note on Nerve Trunk Ischemia

Kesserwani¹

2020

Cureus

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“…The main purpose of treating VAD is either to stabilize the thrombus or to reduce further thrombus formation, which could primarily prevent stroke; However, if a stroke has already occurred, the aim is to prevent progression or recurrence [ 14 ]. So far, only the Cervical Artery Dissection in Stroke Study (CADISS) trial has assessed the use of antiplatelets versus anticoagulants to reduce stroke risk; they concluded that there was no difference between treatment groups either in outcome events or the rate of recanalization [ 15 ]. The treatment of intracranial VAD is much more complicated and warrants optimized management strategies.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Vertebral Artery Dissection Is an Under-Recognized Cause of Stroke in Young Patients: Two Case Reports and Review

Elkady

Ghazal

Alanzi

et al. 2020

Cureus

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Cervicocerebral artery dissection (CAD) is an important and under-recognized cause of strokes in young and middle-aged patients. Spontaneous vertebral artery dissection (VAD) is a rare condition that can potentially cause a stroke without any preceding trauma or other causes of dissection. VAD rarely simulates classical headache syndromes. In this report, we discuss two young patients who were initially misdiagnosed as cases of headache until they presented with ischemic events, and were eventually diagnosed with spontaneous VAD. Case 1 involves a 41year-old male patient who presented with severe headache radiating to left posterior neck pain and dizziness. He was initially misdiagnosed as a case of cervicogenic headache. He was subsequently diagnosed with extracranial VAD complicated by a delayed embolic ischemic stroke. However, he made full recovery within the next few days. Case 2 pertains to a 33-yearold female patient who presented with right-sided headache mimicking migraine; later on, new neurological signs prompted a diagnosis of acute ischemic infarction as a complication of intracranial VAD. In conclusion, VAD should be seriously considered when dealing with patients complaining of the first attack of headache that mimics migraine or those with cervicogenic headaches, which fail to respond to the usual treatment. Moreover, posterior circulation stroke among young patients or stroke with pain in the head and neck should be investigated carefully with extensive neuroimaging. Finally, prompt and accurate diagnosis of VAD followed by proper treatment is crucial for good outcomes and will prevent disability or even fatal complications in patients.

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“…Diagnosis should be confirmed by imaging (including conventional angiography, CT angiography, magnetic resonance angiography or Doppler ultrasound imaging). Of note, 20% of cases of dissection in the CADISS trial could not be confirmed following central review of imaging, 13 highlighting the challenges in definitive diagnosis. Studies that do not list their radiological diagnostic criteria will not be excluded but any specific criteria used for diagnosis will be noted in the data extraction form and this will be considered in the final interpretation of results.…”

Section: Methods and Analysismentioning

confidence: 99%

Recurrence of cervical artery dissection: protocol for a systematic review

et al. 2020

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IntroductionCervical artery dissection, including carotid and vertebral artery dissection, is an important cause of stroke in the young. Risk of developing cervical artery dissection has been associated with physical activity in various forms and has been presumed to be related to minor trauma and mechanical stretching of the cervical arteries. This systematic review will aim to synthesise data on the risk of recurrent cervical artery dissection after an initial dissection. This information may be applied to further understand the natural history of this disease, and potentially to help direct evidence-based discussions on safe return to activity after dissection.Methods and analysisA broad search of multiple electronic databases (Medline, Embase, Cochrane Central Register of Controlled Trials and Web of Science) will be conducted to identify studies published as of 13 November 2019, examining all-comers with cervical artery dissection observed over time. Studies will be screened by two independent reviewers in a two-level process to determine eligibility for inclusion. Data will be pooled from eligible articles and the main outcome of recurrent cervical artery dissection at 5 years will be determined using quantitative analysis.Ethics and disseminationEthics approval is not necessary as no primary data are being collected. The information will be disseminated in the form of a systematic review article which will be submitted to a peer-reviewed medical journal.PROSPERO registration numberCRD42020166105.

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Antiplatelet Therapy vs Anticoagulation Therapy in Cervical Artery Dissection: The Cervical Artery Dissection in Stroke Study (CADISS) Randomized Clinical Trial Final Results.

Abstract: The country you live in plays a large part in whether you undergo carotid endarterectomy

Cited by 50 publications

References 0 publications

Isolated Palsy of the Cisternal Segment of the Hypoglossal Nerve Due to Arterial Dissection of the V4 Segment of the Vertebral Artery: A Case Report With a Side Note on Nerve Trunk Ischemia

Isolated Palsy of the Cisternal Segment of the Hypoglossal Nerve Due to Arterial Dissection of the V4 Segment of the Vertebral Artery: A Case Report With a Side Note on Nerve Trunk Ischemia

Spontaneous Vertebral Artery Dissection Is an Under-Recognized Cause of Stroke in Young Patients: Two Case Reports and Review

Recurrence of cervical artery dissection: protocol for a systematic review

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