Sensitivity of neurovascular ultrasound for the detection of spontaneous cervical artery dissection

Nebelsieck, J.; Sengelhoff, Christian; Naßenstein, I.; Maintz, David; Kuhlenbäumer, Gregor; Nabavi, Darius G.; Ringelstein, E. B.; Dittrich, Ralf

doi:10.1016/j.jocn.2008.04.005

Cited by 61 publications

(40 citation statements)

References 23 publications

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“…100 Others have found abnormalities on ultrasonogram in 29 of 31 VADs 31 and 24 of 26 VADs. 186 VADs that were normal on ultrasonogram were nonocclusive. 31 In ICADs presenting only with a Horner syndrome, ultrasonogram was abnormal in only 69%.…”

Section: Duplex Ultrasonographymentioning

confidence: 93%

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Biller¹,

Sacco²,

Albuquerque³

et al. 2014

Stroke

175

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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.

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Section: Duplex Ultrasonographymentioning

confidence: 93%

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Biller¹,

Sacco²,

Albuquerque³

et al. 2014

Stroke

175

View full text Add to dashboard Cite

show abstract

“…Some advocate the use of Doppler ultrasound;15 however, it has limited utility given the course of the vertebral artery in the neck and limited evaluation of the vertebral arteries cephalad to the origin. Additionally, ultrasound imaging is unlikely to allow visualisation of the dissection itself and thus can be negative in the absence of significant arterial occlusion 16 17…”

Section: Discussionmentioning

confidence: 99%

Vertebral artery dissection in evolution found during chiropractic examination

et al. 2015

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A 30-year-old woman presented to an emergency department with sudden onset of transient loss of left peripheral vision. Owing to a history of migraine headaches, she was released with a diagnosis of ocular migraine. Two days later, she sought chiropractic care for the chief symptom of severe neck pain. The chiropractor suspected the possibility of vertebral artery dissection (VAD). No manipulation was performed; instead, MR angiography (MRA) of the neck was obtained, which revealed an acute left VAD with early thrombus formation. The patient was placed on aspirin therapy. Repeat MRA of the neck 3 months later revealed resolution of the thrombus, without progression to stroke. This case illustrates the importance for all healthcare providers who see patients with neck pain and headache to be attentive to the symptomatic presentation of possible VAD in progress.

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“…El doppler de vasos de cuello se puede utilizar inicialmente como tamizaje ante la sospecha de esta entidad o para hacer seguimiento posterior al inicio del tratamiento, teniendo en cuenta que es operador dependiente y detecta anormalidades en el 68 al 95 % de los casos (14,15). Para el manejo se ha utilizado la terapia antitrombótica, ya sea con anticoagulación o antiagregación; hasta el momento no se han encontrado diferencias entre el tratamiento con estas dos terapias, siendo aún igual de efectivas para la prevención del accidente cerebrovascular recurrente (16).…”

Section: El Estudio Cadisp (Siglas En Inglés De Cervical Artery Disseunclassified

Disección espontánea de la arteria vertebral

Caicedo¹,

López

Cardozo

2016

CES Med

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ResumenLa disección arterial como causa de ataque cerebrovascular es infrecuente, presentándose más comúnmente en población joven asociado a un trauma menor que involucra la hiperextensión del cuello. Presentamos el reporte de un paciente hombre, joven, con un accidente cerebrovascular de fosa posterior y cuya etiología fue una disección espontánea de la arteria vertebral derecha.Palabras clave: Disección de arteria vertebral, Accidente cerebrovascular, Accidente cerebrovascular. AbstractArterial dissection as a cause of stroke is uncommon, most commonly presenting in young people sometimes associated with trauma involving hyperextension of the neck as the only history which would suggest the traumatic origin. We present the case report of a young man with posterior stroke whose etiology was a spontaneous dissection of the right vertebral artery.Keywords: Vertebral artery dissection, Stroke, Cerebrovascular trauma. IntroducciónOcasionalmente los eventos isquémicos cerebrales pueden tener un sustrato derivado de una disección arterial carotídea o vertebral (1). La disección traumática ocurre en el 1 al 2 % del trauma grave no penetrante de las arterias cervicales y se asocia frecuentemente con fracturas faciales, de la base de cráneo, de vértebras cervicales, de trauma encéfalocraneano y lesión medular.No obstante, y con una mayor frecuencia, se ha reportado en ausencia de trauma directo severo pero en relación a trauma menor y baja energía (p.e. manipulación del cuello o hiperextensión) y en este caso se califica como disección espontánea. Debido a que este tipo de lesiones tienen una baja incidencia, se piensa poco en ellas y no se diagnostican, y mucho menos cuando no se asocian a un trauma menor (2).A continuación reportamos el caso de un paciente con una disección espontánea de la arteria vertebral derecha que inició con vértigo y en quien se documentó un infarto cerebeloso.

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Sensitivity of neurovascular ultrasound for the detection of spontaneous cervical artery dissection

Cited by 61 publications

References 23 publications

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Vertebral artery dissection in evolution found during chiropractic examination

Disección espontánea de la arteria vertebral

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