Outcomes and prognostic factors of intracranial unruptured vertebrobasilar artery dissection

Kim, B. M.; Kim, S. H.; Kim, D. I.; Shin, Yong Sam; Suh, Sang Hyun; Kim, D. J.; Park, S. I.; Park, K. Y.; Ahn, Sung Soo

doi:10.1212/wnl.0b013e31821a7d94

Cited by 131 publications

(118 citation statements)

References 25 publications

Supporting

Mentioning

113

Contrasting

Order By: Relevance

“…7 Our study of golf-related vertebral artery dissection shows that extracranial involvement is more frequent than intracranial involvement. As compared with either their intracranial segments or extracranial arteries of similar caliber, greater mobility of the extracranial segments of the carotid and vertebral arteries leads to increased susceptibility for injury by surrounding hard structures including bones, ligaments, and contracted muscles.…”

Section: Discussionmentioning

confidence: 79%

“…[3][4][5][6] Previous case studies have reported cervical artery dissection associated with sudden hyperextension or rotation of the neck, including painting a ceiling, coughing, vomiting, sneezing, receiving anesthesia, and during cardiopulmonary resuscitation. [7][8][9] Cervical artery dissection caused by physical activity represents a coincidental environmental trigger, and certain risk factors such as connective tissue disorders or hyperhomocysteinemia are associated with this type of injury. 10 Because the golf swing is a habitual body motion that includes rapid head and body rotation, it may lead to repetitive mechanical compression of the extracranial cervical arteries during each swing.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke

Choi

Hong

Lee

et al. 2013

American Journal of Neuroradiology

View full text Add to dashboard Cite

SUMMARY:Golf-related stroke has not been systematically reviewed. The purpose of our study was to describe in detail this particular stroke syndrome. Seven patients were analyzed at a university hospital and 7 patients were reviewed from MEDLINE literature. General demographics, symptom onset, neurologic signs, radiologic findings, and outcome were investigated. A total of 14 patients including 7 patients from the MEDLINE search were analyzed; all were men, with a mean age of 46.9 Ϯ 12.8 years. Symptom onset was classified as during the golf swing (n ϭ 9), unknown (n ϭ 3), and after playing golf (n ϭ 2). Most patients (n ϭ 12) showed involvement of the vertebral artery and 2 patients showed involvement of the internal carotid artery (P ϭ .008). Nine dissections were found on the right side, 3 on the left side, and 2 were bilateral (P ϭ .046). Twelve patients had extracranial involvement and 2 patients had intracranial involvement (P ϭ .008). Seven patients returned to normal, 5 returned to independence, 1 had unknown status, and 1 died. The anatomic preference of golf-related craniocervical arterial dissection is associated with the extracranial and vertebrobasilar system with a right-sided tendency as the result of stereotypical rotational movement during a golf swing. ABBREVIATION: VA ϭ vertebral artery

show abstract

Section: Discussionmentioning

confidence: 79%

mentioning

confidence: 99%

Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke

Choi

Hong

Lee

et al. 2013

American Journal of Neuroradiology

View full text Add to dashboard Cite

show abstract

“…Kim et al 8 reported their large series of 191 patients with unruptured vertebrobasilar artery dissections, including ischemic and nonischemic symptoms, in which 81 patients presented with headache only. All were treated either endovasculary (n ϭ 46) or by medical therapy with anticoagulation (n ϭ 49), antiplatelet therapy (n ϭ 48), or analgesics (n ϭ 48).…”

Section: Management Strategy and Clinical Findingsmentioning

confidence: 99%

Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke

Kobayashi¹,

Murayama²,

Yuki³

et al. 2014

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…In general, clinical outcomes for symptomatic intracranial unruptured vertebrobasilar artery dissections are favorable in all patients without ischemic symptoms and in most patients with ischemic symptoms (11). In a retrospective analysis by Saeed et al evaluating the prognosis in 26 patients after vertebral artery dissection, 40% had no residual symptoms, 40% had minimal residual symptoms, and 10% had permanent disabling defi cits.…”

Section: Discussionmentioning

confidence: 99%

Vertebral Artery Dissection After a Chiropractor Neck Manipulation

Jones¹,

Jones²,

Nugent³

2015

Baylor University Medical Center Proceedings

View full text Add to dashboard Cite

The differential diagnosis for ischemic central nervous system infarcts in young patients includes paradoxic emboli through cardiac shunts, vasculitis, and vascular trauma. We report a young woman who developed headache, vomiting, diplopia, dizziness, and ataxia following neck manipulation by her chiropractor. A computed tomography scan of the head revealed an infarct in the inferior half of the left cerebellar hemisphere and compression of the fourth ventricle causing moderate acute obstructive hydrocephalus. Magnetic resonance angiography revealed severe narrowing and low flow in the intracranial segment of the left distal vertebral artery. The patient was treated with mannitol and a ventriculostomy and had an excellent functional recovery. This report illustrates the potential hazards associated with neck trauma, including chiropractic manipulation. The vertebral arteries are at risk for aneurysm formation and/or dissection, which can cause acute stroke. Y oung patients may develop central nervous system infarcts following cardioembolic events, paradoxic emboli through intracardiac shunts, vasculitis, and vascular trauma in the neck. We describe a patient who developed posterior circulation symptoms following chiropractic manipulation of her neck. Th is case illustrates the hazards associated with neck manipulation and the potential for good outcomes in these patients if they develop a stroke syndrome. CASE DESCRIPTIONA 38-year-old female schoolteacher with no signifi cant past medical history presented with headache, nausea, vomiting, blurred vision, diplopia, dizziness, and ataxia for 2 to 3 weeks. Th ese symptoms started after a visit to her chiropractor and neck manipulation. Her symptoms were further exacerbated by hanging decorations from the ceiling at work. Her level of consciousness gradually decreased over the same time period. She was not taking any medications on admission and denied allergies and use of tobacco, alcohol, or illicit drugs. She was married and had two children. On examination, she was drowsy but aroused with sternal rubs. Her temperature was 97.6°F; heart rate, 71 beats per minute; blood pressure, 144/92 mm Hg; and respiratory rate, 18 breaths per minute. She was disoriented and followed simple commands poorly. She demonstrated nystagmus to the left. She moved all extremities but had left-sided weakness (3/5) with hyperrefl exia. Cardiac, respiratory, and abdominal examinations were within normal limits. Her white blood cell count was 13 k/μL; hemoglobin, 13.7 g/dL; and platelets, 286 k/μL. Renal and liver function tests, electrolytes, and coagulation times were within normal limits.A computed tomography (CT) scan of her head performed on admission showed a non-contrast-enhancing process involving the inferior half of the left cerebellar hemisphere (Figure 1a). Th ere was extensive mass eff ect with displacement, distortion, and compression of the fourth ventricle causing moderate acute obstructive hydrocephalus and displacement of the cerebellar vermis to the right. Th ere was mil...

show abstract

Outcomes and prognostic factors of intracranial unruptured vertebrobasilar artery dissection

Cited by 131 publications

References 25 publications

Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke

Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke

Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke

Vertebral Artery Dissection After a Chiropractor Neck Manipulation

Contact Info

Product

Resources

About