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Stroke and Transient Ischemic Attacks of the Brain and Eye
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Cervical artery dissection is the second most common type of large artery disease causing ischemic stroke, and the most common cause of ischemic stroke in young people.7 The annual incidence is about 3 per 100,000 individuals, and the mean age is about 45 years.
Neurosurgery: Cerebrovascular diseases
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Paolo Gritti, Luigi Andrea Lanterna, Francesco Ferri, Carlo Brembilla, Ferdinando Luca Lorini
Common stroke signs and symptoms may include sudden onset of weakness, hemiparesis, monoparesis, or rarely quadriparesis, hemisensory deficits, visual loss or visual field deficits, diplopia, dysarthria, altered speech, aphasia, facial droop, ataxia, vertigo, nystagmus, and sudden decrease in the level of consciousness (14). Although such symptoms can occur alone, they are more likely to occur in combination. No historical feature distinguishes ischemic from hemorrhagic stroke, although nausea, vomiting, headache, and sudden change in the level of consciousness are the most common in hemorrhagic strokes. In younger patients, a history of recent trauma, coagulopathies, illicit drug use (such as cocaine), migraines, or use of oral contraceptives should be elicited. Associated symptoms vary and usually reflect the cause or the consequence of the stroke. For example, headache occurs in about a quarter of patients with acute IS, half of patients with ICH, and nearly all patients with SAH (14–16). Headache may also reflect the underlying cause of the stroke, such as cervical artery dissection or giant cell arteritis, or be the consequence of cortical ischemia or intracranial hemorrhage (14).
Cervical artery dissection: fibromuscular dysplasia versus vascular Ehlers–Danlos syndrome
Published in Blood Pressure, 2019
Caroline Henrard, Hendrica Belge, Sophie Fastré, Silvia Di Monaco, Nicole Revencu, Frank Hammer, Agnès Pasquet, Alexandre Persu
In case of cervical artery dissection occurring in a patient below 60 years of age, especially in presence of a suggestive family history, all efforts should be made to diagnose the underlying arterial disease, in order to optimize management and limit the risk of serious and potentially fatal complications in the affected patient and her/his relatives. In particular, obtaining a detailed family history is essential. Although vEDS is considered as a rare cause of carotid dissection, the existence of a family history of arterial dissection, the occurrence of a carotid-cavernous fistula and other complications suggestive of a connective tissue disease (in this case colonic and uterine perforation) should prompt physicians to seriously consider this diagnosis and perform the corresponding genetic tests.
A risk–benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: a comprehensive review
Published in Annals of Medicine, 2019
Aleksander Chaibi, Michael Bjørn Russell
Cervical artery dissection (CAD) refers to a tear in the internal carotid artery (ICA) or the vertebral artery (VA), resulting in an intramural haematoma and/or an aneurysmal dilatation, which can ultimately be detrimental to the individual. The pathophysiology of CAD is not fully understood, but multiple coexisting pathological processes leading to a predisposing weakness of the arterial wall, namely, a large aortic root diameter, increased stiffness of the carotid wall, material and circumferential wall stress, hypertension, endothelial dysfunction, and arterial redundancies, have been proposed to increase the risk of CAD [1].
Response to commentary by Pikus and Harbaugh on: a risk-benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: a comprehensive review
Published in Annals of Medicine, 2019
Aleksander Chaibi, Michael Bjørn Russell
Spinal manual-therapy roughly equals every day movements. Fortunately, this usually does not cause cervical artery dissection (CAD). The most common initial symptoms of CAD are headache and pain location as illustrated in figure 2 [2], which do not adhere to Pikus and Harbaugh comments.