A Patient With Internal Carotid Artery Dissection

Willett, Gilbert M.; Wachholtz, Neal A.

doi:10.2522/ptj.20100217

Cited by 10 publications

(4 citation statements)

References 39 publications

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“…Post hoc tests identified four homogenous subsets with regard to age: golf players were significantly older than participants of football, basketball, and combat sports; football players were also significantly younger than runners, tennis players, and people engaging in exercise/weight lifting and scuba diving (Figure 1(a)). The proportion of female patients also differed significantly 36 1 À Springboard diving 37 1 À Wakeboarding 38 1 À Waterskiing 39 1 À Surfing 40 1 À Kitesurfing 41 1 À Running/jogging 22 129 3 À Handball 74 1 À Hockey 78 1 À Paddle bal 40 1 À Bowling 84 1 À a Indicates which types of sports are included in between-group analyses (all groups with at least 10 cases). 'Yes': forming a main group, '(þ)': part of main group, 'À': not included in further analysis, '/': some of its constituents are included in between-group analyses.…”

Section: Resultsmentioning

confidence: 99%

Cervical artery dissection after sports – An analytical evaluation of 190 published cases

Schlemm

Nolte

Engelter

et al. 2017

European Stroke Journal

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Introduction: Cervical artery dissections may be preceded by mechanical trigger events, often related to sports. Methods: Using the MEDLINE database, we identified case reports and case series of sports-related cervical artery dissections. Information of the type of sport, age and gender of the patient, affected vessels, associated infarction, time delay, and neurological sequelae were extracted. Demographic and clinical characteristics were compared between sport groups using analysis of variance and Chi square tests. Differences were further assessed with adjusted post hoc tests and homogenous subsets. Results: A total of 115 reports describing 190 patients with cervical artery dissections related to 45 different sports were identified. The mean age of all patients was 35 years; 26% of all patients were women. Anterior and posterior circulation, as well as left and right side were affected with similar frequency. Patients belonging to different sport categories differed significantly with regard to age (p < 0.001), gender (p < 0.001), and affected circulation (anterior vs. posterior, p ¼ 0.02). The posterior circulation was most often affected in golf players (88%) and least often in individuals engaging in exercise (23%) and scuba divers (29%). Laterality (left vs. right) and mortality were similar between sport groups. Discussion: We performed a comprehensive review and analytical evaluation of case reports describing patients with cervical artery dissections after sport. Confirmation of our findings in prospective studies is needed. Conclusion: Cervical artery dissection has been described in relation to a wide variety of sports. The risk of injury to particular neurovascular structures may depend on the type sport involved. Discipline-specific incidence rates are not known.

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Section: Resultsmentioning

confidence: 99%

Cervical artery dissection after sports – An analytical evaluation of 190 published cases

Schlemm

Nolte

Engelter

et al. 2017

European Stroke Journal

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“…Existem vários estudos que relacionam o exercício físico com este evento, nomeadamente a prática de desportos aquáticos (mergulho ou natação), levantamento de pesos, desportos de combate, golfe, futebol, entre outros. [7][8][9] Neste caso clínico, o síndroma de Horner apresenta-se, assim, como uma consequência da prática de levantamento de pesos, devido à disrupção das fibras nervosas simpáticas em torno da artéria carótida interna.…”

Section: Comentáriounclassified

Quando mais uma série de supino no ginásio acaba o dia como síndroma de Horner

Duarte¹,

Ferreira²,

Magalhães³

2022

RPMGF

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Introdução: O síndroma de Horner representa um importante desafio na prática clínica, uma vez que pode estar associada a uma grande variedade de etiologias. Trata-se de um síndroma rara, que se manifesta classicamente por anisocoria com miose, ptose palpebral e anidrose homolateral devido à perda de inervação simpática. Este caso pretende relatar um síndroma de Horner desencadeado após a prática de exercício físico e demonstrar a importância de uma história clínica e de um exame físico detalhados, assim como uma abordagem multidisciplinar na avaliação de um doente com síndroma de Horner em contexto de serviço de urgência. Descrição do caso: Homem, 51 anos, recorreu ao serviço de urgência por ptose palpebral e dor na hemiface após exercício físico no ginásio. Ao exame físico destacava-se pupilas anisocóricas, com miose à esquerda e ptose palpebral homolateral, sem outros achados. Solicitou-se estudo analítico com hemograma e bioquímica, que não revelou alterações, e angio-tomografia cerebral e dos troncos supra-aórticos que, após uma revisão das imagens que inicialmente pareciam sem alterações, revelou disseção da artéria carótida interna esquerda. O doente foi internado e iniciou terapêutica médica com resolução dos sintomas às 24 horas após a entrada no serviço de urgência, tendo permanecido em vigilância durante 48 horas. Comentário: Com este caso clínico pretende-se demonstrar que, mesmo perante um diagnóstico de um síndroma potencialmente fatal como é o síndroma de Horner, é possível uma boa evolução clínica com resolução célere das queixas apresentadas. Sendo que para este desiderato foi determinante uma conjugação de fatores, desde a história clínica completa ao exame objetivo minucioso, bem como exames auxiliares de diagnóstico usados de forma criteriosa, num processo integrado entre médicos de diferentes especialidades.

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“… 3 Cervical artery dissection is frequently associated with participation in sports and physical activity, presumably related to minor trauma or neck movements causing mechanical stretching of these vessels. 4 5 In case reports, cervical artery dissection has been associated with running, 6 7 swimming, 8 golf, 9 extreme conditioning programmes, 10 waterskiing 11 and volleyball, 12 among other examples. 4 …”

Section: Introductionmentioning

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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A Patient With Internal Carotid Artery Dissection

Abstract: Background and Purpose. The purpose of this case report is to raise physical

Cited by 10 publications

References 39 publications

Cervical artery dissection after sports – An analytical evaluation of 190 published cases

Cervical artery dissection after sports – An analytical evaluation of 190 published cases

Quando mais uma série de supino no ginásio acaba o dia como síndroma de Horner

Recurrence of cervical artery dissection: protocol for a systematic review

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