Stroke Occurrence and Patterns Are Not Influenced by the Degree of Stenosis in Cervical Artery Dissection

Naggara, Olivier; Morel, A; Touzé, Emmanuel; Raymond, Jean; Mas, Jean‐Louis; Méder, Jean-François; Oppenheim, Catherine

doi:10.1161/strokeaha.111.639021

Cited by 23 publications

(13 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Major and minor cervical trauma [13][14][15][16][17] Arterial hypertension [18][19][20] Young age 12 Current use of oral contraceptives 21 Migraine [22][23][24] Fibromuscular dysplasia 11,[25][26][27][28][29][30][31][32] Ultrastructural connective tissue abnormalities 33 Vascular subtype of Ehlers-Danlos syndrome 34 Marfan syndrome 18,35 Turner syndrome 19,36 Williams syndrome 37 Familial cases 18,38 Hereditary hemochromatosis 39 Osteogenesis imperfecta type I 40 α1-Antitrypsin deficiency 41,42 677T genotype MTHFR [43][44][45] Hyperhomocysteinemia 46 Cystic medial necrosis of intracranial vessels 47 Styloid process length 48 ICAM-1 E4690 K gene polymorphism 49 Autosomal-dominant polycystic kidney disease 50 Infections [51][52][53][54] Moyamoya disease …”

Section: Table 1 Factors Associated With CDmentioning

confidence: 99%

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Biller¹,

Sacco²,

Albuquerque³

et al. 2014

Stroke

179

View full text Add to dashboard Cite

3155Purpose-Cervical artery dissections (CDs) are among the most common causes of stroke in young and middle-aged adults.The aim of this scientific statement is to review the current state of evidence on the diagnosis and management of CDs and their statistical association with cervical manipulative therapy (CMT). In some forms of CMT, a high or low amplitude thrust is applied to the cervical spine by a healthcare professional. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were assigned topics relevant to their areas of expertise and reviewed appropriate literature, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. Results-Patients with CD may present with unilateral headaches, posterior cervical pain, or cerebral or retinal ischemia (transient ischemic or strokes) attributable mainly to artery-artery embolism, CD cranial nerve palsies, oculosympathetic palsy, or pulsatile tinnitus. Diagnosis of CD depends on a thorough history, physical examination, and targeted ancillary investigations. Although the role of trivial trauma is debatable, mechanical forces can lead to intimal injuries of the vertebral arteries and internal carotid arteries and result in CD. Disability levels vary among CD patients with many having good outcomes, but serious neurological sequelae can occur. No evidence-based guidelines are currently available to endorse best management strategies for CDs. Antiplatelet and anticoagulant treatments are both used for prevention of local thrombus and secondary embolism. Case-control and other articles have suggested an epidemiologic association between CD, particularly vertebral artery dissection, and CMT. It is unclear whether this is due to lack of recognition of preexisting CD in these patients or due to trauma caused by CMT. Ultrasonography, computed tomographic angiography, and magnetic resonance imaging with magnetic resonance angiography are useful in the diagnosis of CD. Follow-up neuroimaging is preferentially done with noninvasive modalities, but we suggest that no single test should be seen as the gold standard.

show abstract

Section: Table 1 Factors Associated With CDmentioning

confidence: 99%

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Biller¹,

Sacco²,

Albuquerque³

et al. 2014

Stroke

179

View full text Add to dashboard Cite

show abstract

“…The rationale for the use of heparin is based on indirect evidence that most infarcts following CAD are of embolic origin [14,15,16]. The cornerstone of CAD pathophysiology is a mural accumulation of blood due to disruption of the vasa vasorum [17].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with occlusive CAD were excluded, since further worsening of the lumen was not possible. Given that occlusive CAD was associated with larger and hemodynamic infarcts [15,16], exclusion of occlusive CAD might have underestimated recurrent DWI lesion or occurrence of hemorrhagic transformation. MRI 1 was performed and treatment was initiated many days after occurrence of the mural hematoma; consequently, the number of patients with mural hematoma enlargement may have been underestimated due to hematoma stabilization.…”

Section: Discussionmentioning

confidence: 99%

Does Anticoagulation Promote Mural Hematoma Growth or Delayed Occlusion in Spontaneous Cervical Artery Dissections?

Machet¹,

Fonseca

Oppenheim³

et al. 2013

Cerebrovasc Dis

View full text Add to dashboard Cite

Background: In case of spontaneous cervical artery dissection (CAD), a medical treatment with anticoagulant or antiplatelet (AP) drugs would avoid the occurrence of an ischemic stroke. Although immediate anticoagulation (AC) is advocated, evidence from randomized trials is lacking. Since CAD is characterized by a mural accumulation of blood, the dissecting hematoma may enlarge under AC, with subsequent lumen narrowing. Although direct evidence of mural hematoma enlargement is lacking in the literature, such a complication may not only be theoretical. Magnetic resonance imaging (MRI) of the mural hematoma on transverse sections through the neck is the current diagnostic gold standard. Our aim was to compare the evolution of the mural hematoma in CAD during the first week after treatment initiation (AP agent: group_AP, AC: group_AC), using dedicated cervical MRI of the arterial wall. Methods: The study was -approved by the Ethics Committee of Ile de France III. Informed consent was waived. The manuscript was prepared in accordance with the STROBE statement. Fast spin-echo T1-weighted fat-suppressed axial sequences were performed at admission (MRI₁) and during the first week after initiation of the treatment (MRI₂). Two readers measured volumes, craniocaudal length of the mural hematoma and lumen patency, and searched for early recurrent CAD. They also searched for extension or recurrence of ischemic brain lesions and for hemorrhagic transformation on diffusion-weighted imaging (DWI) and gradient echo T2 (T2*) sequences, respectively. Results: The population included 44 patients (31 in group_AC, 13 in group_AP) with 49 CAD (35 carotid, 14 vertebral). Recurrent CAD and reduction of the lumen did not occur in either group. We did not observe recurrent DWI lesions or occurrence of hemorrhagic transformation. Interobserver agreement [intraclass correlation coefficient (95% CI)] was excellent for volume measurement [0.98 (0.97-0.99) and 0.99 (0.98-1.0) for volume₁ and volume₂, respectively]. While mean volumes and length of the mural hematoma decreased after treatment in both groups (volume: group_AC -13 ± 22%, group_AP -12 ± 24%, p = 0.33; length: group_AC -10 ± 27%, group_AP -10 ± 20%, p = 0.18), approximately one third of patients in each group had some growth of the mural hematoma as well as an increase in length. Conclusion: Limited growth of the mural hematoma was seen with both treatments in approximately one third of patients during the first week after treatment initiation. However, neither AC nor AP agents promote reduction of the lumen or recurrent dissection.

show abstract

“…Occlusive lesions lead to larger infarcts, with most of the infarcts occurring within the first 3-5 days after the dissection [10].…”

Section: Discussionmentioning

confidence: 99%

Malignant Middle Cerebral Artery Infarction Secondary to Traumatic Bilateral Internal Carotid Artery Dissection. A Case Report

Bajkó

Bălaşa

Moţăţăianu

et al. 2016

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

Traumatic bilateral dissection of the carotid arteries is a rare condition with potentially life-threatening complications. The case of a 57-year-old male patient with acute onset left sided hemiparesis, twelve hours after a blunt head injury, caused by a horse kick, is reported. A cerebral CT scan revealed right middle cerebral artery (MCA) territory infarction. Based on Duplex ultrasound and Angio CT scan findings, a diagnosis of bilateral ICA dissection was established. Despite antithrombotic treatment, the patient presented with a progressive worsening of his neurological status. The control CT scan evidenced malignant right MCA territory infarction that required decompressive craniotomy. The patient was discharged with significant neurological deficits. Together with this case, the aetiologies, clinical manifestations, diagnostic and therapeutical options and outcome of carotid artery dissection are discussed.

show abstract

Stroke Occurrence and Patterns Are Not Influenced by the Degree of Stenosis in Cervical Artery Dissection

Cited by 23 publications

References 10 publications

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Does Anticoagulation Promote Mural Hematoma Growth or Delayed Occlusion in Spontaneous Cervical Artery Dissections?

Malignant Middle Cerebral Artery Infarction Secondary to Traumatic Bilateral Internal Carotid Artery Dissection. A Case Report

Contact Info

Product

Resources

About