Vertebral Artery Dissection : Natural History, Clinical Features and Therapeutic Considerations

Park, Kwan-Woong; Park, Jongsun; Hwang, Sun Chul; Im, Soo Bin; Shin, Won-Han; Kim, Bum‐Tae

doi:10.3340/jkns.2008.44.3.109

Cited by 77 publications

(64 citation statements)

References 47 publications

(66 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4 Park et al (2008) described that magnetic resonance techniques are now replacing conventional angiography as the gold standard in the diagnosis of dissections of the vertebral arteries, because the resolution of magnetic resonance angiography now approaches that of conventional angiography, and magnetic resonance imaging can show the intramural hematoma itself. 5 VA is a branch of first part of subclavian artery and arises from its posterosuperior aspect. The artery is divided into four parts:…”

Section: Introductionmentioning

confidence: 99%

“…7 Park et al (2008) have described that the VA is most mobile and thus most vulnerable to mechanical injury at C1 to C2 as it leaves the transverse foramen of the axis vertebra and suddenly turns to enter the cranial cavity. 5 Knowledge of variability and anatomical features of the VA in different human populations gives the main clues for understanding and prognosis of the pathological processes in the studied area. 4 this study has been undertaken as no reports on the histology of various segments of the VA are available for the central Indian population.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Histological Variations in Various Segments of Vertebral Artery

Bhadkaria¹,

Chawre²,

Joshi³

et al. 2016

jemds

View full text Add to dashboard Cite

Compromise of vertebrobasilar circulation results in ischaemia of brainstem and cerebellar structures. Vertebral Artery (VA) follows a unique, long and tortuous course through the neck and cranium. It is divisible into 4 distinct parts. This seems to be the nature's way to allow for the movements of neck without altering the blood supply to the vital organs. MATERIAL AND METHODSVA were dissected in cadavers throughout its length on both the sides and the following segments V1: part (Proximal, Distal), V2: part, V3: part, and V4: part (Proximal, Distal) were removed. Tissues were processed and were stained with hematoxylin and eosin, Orcein and Masson's trichrome stains. RESULT AND CONCLUSIONA higher incidence of thickening of SET showed variability in the thickness. Wavy character, straight outline or at places interruption IEL is suggestive of patchy atherosclerosis in the vessel which may lead to the narrowing of the lumen and during pressure or stretching due to rotational movement may compromise the blood supply leading to vertebrobasilar syndrome. In some vessels presence of a thrombus with an attempt to canalization indicates that if there is no efficient collateral circulation the areas supplied may suffer from ischaemia.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Histological Variations in Various Segments of Vertebral Artery

Bhadkaria¹,

Chawre²,

Joshi³

et al. 2016

jemds

View full text Add to dashboard Cite

show abstract

“…29 Treatment of VAD is directed at preventing thromboembolic complications that may lead to stroke. 30 This is achieved with anticoagulant or antiplatelet medication, providing the patient has no contraindication to antithrombotic therapy. 22 Most extracranial VADs carry a good prognosis, heal spontaneously with time, and rarely require surgical intervention unless complicated by other factors, such as intracranial extension.…”

Section: Discussionmentioning

confidence: 99%

“…22 Most extracranial VADs carry a good prognosis, heal spontaneously with time, and rarely require surgical intervention unless complicated by other factors, such as intracranial extension. 30 Further research is necessary to elucidate the relationship between SMT and VAD. Diagnostic imaging provides the definitive diagnosis of VAD, but prior to imaging the clinician is left with only clinical suspicion.…”

Section: Discussionmentioning

confidence: 99%

Recognition of Spontaneous Vertebral Artery Dissection Preempting Spinal Manipulative Therapy: A Patient Presenting With Neck Pain and Headache for Chiropractic Care

Mattox

Smith²,

Kettner

2014

Journal of Chiropractic Medicine

View full text Add to dashboard Cite

Objective: The purpose of this case report is to describe a patient who presented to a chiropractic physician for evaluation and treatment of neck pain and headache. Clinical features: A 45-year-old otherwise healthy female presented for evaluation and treatment of neck pain and headache. Within minutes, non-specific musculoskeletal symptoms progressed to neurological deficits, including limb ataxia and cognitive disturbances. Suspicion was raised for cerebrovascular ischemia and emergent referral was initiated. Intervention and outcome: Paramedics were immediately summoned and the patient was transported to a local hospital with a working diagnosis of acute cerebrovascular ischemia. Multiplanar computed tomographic and magnetic resonance imaging with contrast revealed vertebral artery dissection of the V 2 segment in the right vertebral artery. Anticoagulation therapy was administered and the patient was discharged without complications after 5 days in the hospital. Conclusion: This case highlights the potential for patients with vertebral artery dissection to present with nonspecific musculoskeletal complaints. Neurological symptoms may not manifest initially, but their sudden onset indicates the possibility of an ischemic cerebrovascular event. We suggest that early recognition and emergent referral for this patient avoided potential exacerbation of an evolving pre-existing condition and resulted in timely anticoagulation treatment.

show abstract

“…In addition to musculoskeletal injuries, one of the more serious types of injuries reported in the literature is injury to the vertebral artery. Sudden movements in asanas involving excessive neck flexion or extension and inversions with or without predominant weight bearing on the head can lead to vertebral artery injuries by way of mechanical stretching [20]. These injuries include: artery dissection, hemorrhage, thrombus formation (clots), swelling, stenosis (constriction) and stroke.…”

Section: Introductionmentioning

confidence: 99%