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    Efficacy of high-resolution cone-beam CT in the evaluation of perforators in vertebral artery dissection.
    Interv Neuroradiol 2017 Jan 1:1591019917706190. Epub 2017 Jan 1.
    1 Department of Neurosurgery, Kameda Medical Center, Japan.
    Introduction A major complication of internal coil trapping for vertebral artery dissection (VAD) is medullary infarction associated with perforator occlusion. Currently, higher spatial resolution imaging can be obtained with high-resolution cone-beam computed tomography (VASO CT), and the efficacy of perforator visualization adjacent to VAD was examined. Methods Eight patients who underwent internal coil trapping or stent-supported coil embolization underwent VASO CT to evaluate perforators around VAD. Read More

    Analysis of the relationship between the double transverse foramen and the possibility of developing clinical symptoms after whiplash.
    Clin Anat 2017 May 16. Epub 2017 May 16.
    University San Vicente Martir, C/Espartero 7. Valencia, E46007, Valencia, Spain.
    Introduction: Currently there is no information about the possibility of developing clinical symptoms after whiplash in double transverse foramen subjects. Our aim was to test whether subjects with double transverse foramen have an increased risk of presenting with acute headache, dizziness, vertebral artery dissection, and vomiting after whiplash.

    Methods: We recorded the absence/presence of double transverse foramen, and the absence/presence of neck pain, acute headache, dizziness, vertebral artery dissection, and vomiting in 85 patients who had suffered whiplash injuries in car rear-end impacts in road traffic accidents. Read More

    Occipital Bony Abnormality and Multiple Strokes in a Pediatric Patient: Case Report and Review of the Current Literature.
    Child Neurol Open 2016 Jan-Dec;3:2329048X16674597. Epub 2016 Oct 23.
    Department of Neurosurgery, University of Nebraska College of Medicine, Omaha, NE, USA.
    This study presents a case of a 15-year-old boy who had a right vertebral artery dissection with distal embolization from repeated trauma from an occipital bony spicule. The authors hypothesize that this bony spicule was contacting the left vertebral artery during head rotation, resulting in trauma to the vessel and formation of emboli which then showered distally, causing strokes in the posterior circulation of the brain. This specific phenomenon has previously been reported three times, only one of which was in pediatric literature. Read More

    Arterial tortuosity in patients with spontaneous cervical artery dissection.
    Neuroradiology 2017 Jun 11;59(6):571-575. Epub 2017 May 11.
    Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy.
    Purpose: The aim of this study was to test the hypothesis that patients with spontaneous cervical artery dissection (CeAD) have increased arterial tortuosity, and the objective quantification of such a tortuosity may aid in the identification of subjects at increased risk of disease.

    Methods: In the setting of a hospital-based, case-control study, we used the vertebral tortuosity index (VTI) measured on magnetic resonance angiography, a validated method for the assessment and quantification of arterial tortuosity, to compare the degree of tortuosity in a series of consecutive patients with spontaneous CeAD and of age- and sex-matched patients with ischemic stroke unrelated to CeAD (non-CeAD IS) and stroke-free subjects.

    Results: The study group was composed of 102 patients with CeAD (mean age, 44. Read More

    Medially displaced common and internal carotid arteries presenting as a pulsatile mass: Clinicoradiologic analysis of 62 cases.
    Ear Nose Throat J 2017 Apr-May;96(4-5):E1-E7
    Head and Neck Surgery Clinic, Izmir Tepecik Egitim ve Arastirma Hastanesi KBB Klinigi, Gaziler cad. No: 468, 35170 Yenisehir Izmir, Turkey.
    We conducted a prospective study to analyze the medially displaced courses of the common carotid artery (CCA) and the cervical segment of the internal carotid artery (ICA) in patients who were diagnosed with a pulsatile mass on nasopharyngolaryngoscopy and by clinicoradiologic findings. Our study group was made up of 62 patients-40 women and 22 men, aged 30 to 88 years (mean: 63.7)-who presented with a submucosal pseudomass or a bulging mass on the pharyngeal wall with obvious pulsation. Read More

    Unilateral Trans-cerebellomedullary Fissure Approach for Occipital Artery to Posterior Inferior Cerebellar Artery Bypass during Aneurysmal Surgery.
    Neurol Med Chir (Tokyo) 2017 May 9. Epub 2017 May 9.
    Department of Neurosurgery, Faculty of Medicine, Fukuoka University.
    Occipital artery (OA) to the posterior inferior cerebellar artery (PICA) bypass is indispensable for the management of complex aneurysms of the PICA that cannot be reconstructed with surgical clipping or coil embolization. Although OA-PICA bypass is a comparatively standard procedure, the bypass is difficult to perform in some cases because of the location and situation of the PICA. We describe the usefulness of the unilateral trans-cerebellomedullary fissure (CMF) approach for OA-PICA bypass. Read More

    A Case Report of Transient Cortical Blindness After Angiography.
    Neurologist 2017 May;22(3):82-84
    Department of Radiology, Shuang-Ho Hospital, Taipei Medical University and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
    Introduction: Transient cortical blindness (TCB) is a rare complication after angiography and is proposed to be related to contrast extravasation. We present the first case of TCB after angiography that was evaluated using serial arterial spin-labeling magnetic resonance perfusion (ASLMRP) and susceptibility-weighted imaging (SWI).

    Case Report: A 65-year-old woman with dyslipidemia who had been treated for left vertebral artery dissection 3 months previously presented with dizziness and right hemiparesis. Read More

    Vertebral Artery Dissection: a Contemporary Perspective.
    Maedica (Buchar) 2016 Jun;11(2):144-149
    Department of Neurology, Emergency University Hospital, Bucharest, Romania.
    Arterial dissections are among the most frequent causes of stroke in young adults. Usually they are associated with trauma, but as the modern imaging tools are evolving, more dissections are being diagnosed and more etiologies are being described. Vertebral artery dissections (VADs) have the distinct particularity that they can cause ischemic stroke (in the brainstem, cerebellum or even the spinal cord), but also subarachnoid hemorrhage, when the dissection occurs in the intracranial segment of the vertebral artery. Read More

    Vertebral artery dissection following a posterior cervical foraminotomy.
    J Surg Case Rep 2017 Feb 8;2017(2):rjx014. Epub 2017 Feb 8.
    Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia.
    Vertebral artery dissection following a posterior cervical foraminotomy with rhizolysis of the subaxial spine has not been described before. A 46-year-old lady underwent the procedure for a left C6 radiculopathy with a focal disc herniation with no intraoperative complications. Seven hours post-operatively, she developed a right homonymous hemianopia, thalamic dysphasia, gait and memory impairment. Read More

    Clinical Significance of Intraluminal Contrast Enhancement in Patients with Spontaneous Cervical Artery Dissection: A Black-Blood MRI Study.
    Rofo 2017 Apr 26. Epub 2017 Apr 26.
    Radiology Center Rosenheim, Rosenheim, Germany.
    Purpose Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD). Methods 33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2*w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries. Read More

    Flow diverter treatment of intracranial vertebral artery dissecting pseudoaneurysms.
    J Neurointerv Surg 2017 Apr 24. Epub 2017 Apr 24.
    Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.
    Introduction: Intracranial vertebral dissecting pseudoaneurysms are a rare, but increasingly recognized, cause of subarachnoid hemorrhage and ischemic stroke. The risks of aneurysm re-rupture and associated morbidity are high. The use of flow diverter stents for the treatment of these aneurysms has not been well studied. Read More

    Reduced Internal Carotid Artery Flow in Color-coded Carotid Duplex Sonography.
    Acta Neurol Taiwan 2016 Dec;25(4):136-147
    Stroke Center and Department of Neurology, Taipei Tzuchi Hospital, Buddhist Tzu Chi Medical Foundation Taipei; School of Medicine, Tzu Chi University, Hualien, Taiwan.
    Purpose: Reduced flow in the internal carotid artery (ICA) is related to cerebral ischemia. We established a classification of reduced ICA flow through color-coded carotid duplex (CCD) sonography.

    Methods: We retrospectively reviewed 25,000 CCD images in sonography laboratory. Read More

    Anticoagulation vs Antiplatelet Treatment in Patients with Carotid and Vertebral Artery Dissection: A Study of 370 Patients and Literature Review.
    Neurosurgery 2017 Mar;80(3):368-379
    Background: Dissection of the carotid and vertebral arteries is an important cause of stroke in young patients.

    Objective: The objective of this study is to compare antithrombotic treatments in patients with carotid and vertebral dissections.

    Methods: Three hundred seventy patients with carotid and vertebral artery dissections were included. Read More

    [Progress of problems related to the reconstruction of aortic arch in acute type A aortic dissection].
    Zhonghua Wai Ke Za Zhi 2017 Apr;55(4):311-315
    Department of Cardiac Surgery, Beijing Anzhen Hospital of Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
    Aortic arch reconstruction is one of the most challenging operations in aortic surgery. Anatomical abnormalities of the aortic arch, including bovine aortic arch, aberrant right subclavian artery, and single vertebral artery have direct impact on the choice of surgical procedures and methods of brain protection.The risk of aortic arch reconstruction and the difficulty of operation, it is possible to avoid the injury of patients by strictly grasping the indication of operation. Read More

    The risk associated with spinal manipulation: an overview of reviews.
    Syst Rev 2017 Mar 24;6(1):64. Epub 2017 Mar 24.
    Physiotherapy and Biomechanics Research Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark.
    Background: Spinal manipulative therapy (SMT) is a widely used manual treatment, but many reviews exist with conflicting conclusions about the safety of SMT. We performed an overview of reviews to elucidate and quantify the risk of serious adverse events (SAEs) associated with SMT.

    Methods: We searched five electronic databases from inception to December 8, 2015. Read More

    The advantage of ultrasonography in the diagnosis of extracranial vertebral artery dissection: Two case reports.
    Medicine (Baltimore) 2017 Mar;96(12):e6379
    aInstitute of Ultrasound Imaging, Chongqing Medical University, Chongqing, China bDepartment of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, China cDepartment of Ultrasonography, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
    Rationale: With the rapid development in technology of vascular imaging, the detection of artery dissection is also gradually increasing. Cervical artery dissection, including carotid artery and vertebral artery dissection, is associated in at least 20% of young adult patients with stroke. So, the diagnosis of cervical artery has become a great challenge. Read More

    Laparoscopic Nerve-Preserving Sacropexy.
    J Minim Invasive Gynecol 2017 Mar 18. Epub 2017 Mar 18.
    Department of Surgical Sciences, University of Torino, Torino, Italy.
    Study Objective: To demonstrate our developed nerve-preserving technique during laparoscopic sacropexy (LSP) for multicompartment pelvic organ prolapse.

    Design: A step-by-step demonstration of our surgical procedure on video (Canadian Task Force classification II-2). Informed consent was obtained from the subject, and the applicable Institutional Review Board provided approval. Read More

    Medical and Interventional Therapy for Spontaneous Vertebral Artery Dissection in the Craniocervical Segment.
    Biomed Res Int 2017 22;2017:7859719. Epub 2017 Feb 22.
    Department of Neurosurgery, Tenth People's Hospital of Tongji University, Shanghai 200072, China.
    Background and Purpose. Spontaneous vertebral artery dissection (SVAD) is an important reason for posterior-circulation-ischemic stroke in the young and middle-aged population. Although some previous reports reveal a favorable outcome with conservative therapy, it is still controversial in the treatment of SVAD in some specific patients. Read More

    A Previously Unreported Arterial Variant of the Suboccipital Region Based on Cadaveric Dissection.
    J Neurol Surg Rep 2017 Jan;78(1):e40-e42
    Seattle Science Foundation, Seattle, Washington, United States.
    Introduction Several arterial variants have been reported to occur around the posterior arch of the atlas. Understanding the various anomalies and diagnosing them preoperatively can dramatically reduce the risk of surgical insult during neurosurgical procedures. Herein we report a case of an arterial variant found just below the posterior arch of C1. Read More

    Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment.
    Case Rep Emerg Med 2017 9;2017:3931985. Epub 2017 Feb 9.
    Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, 3501 Johnson Street, Hollywood, FL 33021, USA.
    Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. Read More

    The Use of Tissue Plasminogen Activator in the Treatment of Wallenberg Syndrome Caused by Vertebral Artery Dissection.
    J Emerg Med 2017 May 28;52(5):738-740. Epub 2017 Feb 28.
    Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
    Background: Acute cerebrovascular accident (CVA) is a devastating cause of patient morbidity and mortality. Up to 10% of acute CVAs in young patients are caused by dissection of the vertebral or carotid artery. Wallenberg syndrome results from a CVA in the vertebral or posterior inferior artery of the cerebellum and manifests as various degrees of cerebellar dysfunction. Read More

    Cervical artery dissection in patients ≥60 years: Often painless, few mechanical triggers.
    Neurology 2017 Apr 3;88(14):1313-1320. Epub 2017 Mar 3.
    From the Department of Neurology and Stroke Center (C.T., H.G., P.L., S.T.E.), University Hospital Basel and University of Basel; Department of Neurology (D.D., B.G.S., M.A.), University Hospital Berne; Ospedale San Giovanni (B.G.S.), Bellinzona, Switzerland; Department of Neurology (T.M.M., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (S.D.), Bordeaux University Hospital; Inserm U1219 (S.D.), Bordeaux; Bordeaux University (S.D.), France; Department of Neurology (S.D.), Boston University School of Medicine, MA; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Italy; Department of Neurology (M.K., C.G.-G.), Heidelberg University Hospital, Germany; Department of Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Public Health Sciences (B.B.W., A.M.S.), University of Virginia Health System, Charlottesville; Univ Lille 2 (D.L.), INSERM U 1171, CHU Lille, France; Neuro Center (R.B.), Clinic Hirslanden, Zurich, Switzerland; Stroke Unit and Division of Internal and Cardiovascular Medicine (V.C.), University of Perugia, Italy; Centre Hospitalier Universitaire Le Bocage (Y.B.), Dijon, France; Department of Neurology and Neurosurgery (A.C.), Brain Centre Rudolf Magnus, University Medical Centre Utrecht, the Netherlands; Department of Neurology (P.R., H.C.), Lariboisière Hospital, Paris 7 University, DHU Neurovasc Sorbonne Paris Cité, France; Florey Institute of Neuroscience and Mental Health (V.T.); Department of Neurology (V.T.), Austin Health, Heidelberg, Australia; Cerebrovascular Unit (A.B.), IRCCS Foundation C. Besta Neurological Institute, Milan, Italy; Clinics for Neurologic Rehabilitation (T.B.), Kliniken Schmieder, Heidelberg, Germany; Normandie Univ (E.T.), UNICAEN, Inserm U919, Department of Neurology, CHU Caen; Department of Neurology (E.T.), CH Sainte-Anne, University Paris Descartes, France; Department of Neurology (J.J.M.), Sanatorio Allende, Cordoba, Argentina; Department of Neurology (T.T.), Sahlgrenska University Hospital and Institute for Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Basel, Switzerland.
    Objective: In a cohort of patients diagnosed with cervical artery dissection (CeAD), to determine the proportion of patients aged ≥60 years and compare the frequency of characteristics (presenting symptoms, risk factors, and outcome) in patients aged <60 vs ≥60 years.

    Methods: We combined data from 3 large cohorts of consecutive patients diagnosed with CeAD (i.e. Read More

    Dynamic Arterial Compression in Pediatric Vertebral Arterial Dissection.
    Stroke 2017 Apr 28;48(4):1070-1073. Epub 2017 Feb 28.
    From the Divisions of Pediatrics in the Departments of Radiology (N.R.), Neurosurgery (N.R., B.B.), and Neurology (M.D.), Children's Health System of Texas, University of Texas Southwestern Medical Center, Dallas; and Anesthesia for Children (A.H.) and Center for Cerebrovascular Disease in Children (S.B.), Children's Health System of Texas, Dallas.
    Background And Purpose: The pathogenesis of spontaneous pediatric vertebral artery dissections (VAD) is poorly understood but most often involves the V3 segment where C1 rotates on C2. We studied children with VAD with provocative digital catheter angiography and found an association between VAD and rotational compression.

    Methods: Seven boys (12 months to 9 years; median 4 years) presented over 38 consecutive months with V3 VAD and underwent digital catheter angiography with provocative passive bilateral neck rotation. Read More

    Percutaneous Cervical Sympathetic Block for Pain Control after Internal Carotid Artery Dissection. A Report of Two Cases.
    J Vasc Interv Neurol 2017 Jan;9(3):36-40
    Zeenat Qureshi Stroke Institute, St. Cloud, MN 56303, USA.
    Background: Medical treatment of cranio-cervical pain can be suboptimal in patients with internal carotid artery (ICA) dissection. We report the use of cervical sympathetic block for treatment of pain in two patients with ICA dissection.

    Case Reports: A 58-year-old man and a 43-year-old woman presented with severe cranio-cervical pain associated with left and right ICA dissection confirmed by magnetic resonance imaging and cerebral angiography. Read More

    Feasibility and safety of direct catheter-based thrombectomy in the treatment of acute ischaemic stroke. Cooperation among cardiologists, neurologists and radiologists. Prospective registry PRAGUE-16.
    EuroIntervention 2017 May;13(1):131-136
    Charles University, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
    Aims: The aim of this study was to evaluate the role of direct catheter-based thrombectomy (d-CBT, without thrombolysis) and the feasibility and safety of d-CBT performed in an interventional cardiology centre.

    Methods And Results: This single-centre, prospective observational registry based on the pre-specified protocol included three months of follow-up. The decision to perform acute stroke intervention was made by a neurologist based on the clinical and imaging findings. Read More

    Timing of Incident Stroke Risk After Cervical Artery Dissection Presenting Without Ischemia.
    Stroke 2017 Mar;48(3):551-555
    From the Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (N.A.M., A.E.M., G.G., H.K.) and Department of Neurology (A.E.M., H.K.), Weill Cornell Medicine, New York, NY; and Department of Neurology, Columbia University Medical Center, New York, NY (N.A.M.).
    Background And Purpose: Cervical artery dissection is a common cause of stroke in young people. The temporal profile of stroke risk after cervical artery dissection presenting without ischemia remains uncertain.

    Methods: We performed a crossover cohort study using administrative claims data on all emergency department visits and acute care hospitalizations from 2005 to 2011 in CA, 2006 to 2013 in NY, and 2005 to 2013 in FL. Read More

    Transverse process anatomy as a guide to vertebral artery exposure during anterior cervical spine approach: A Cadaveric Study.
    Clin Anat 2017 May 4;30(4):492-497. Epub 2017 Apr 4.
    333 North Texas Avenue, Webster, Texas.
    Safe exposure of the vertebral artery (VA) is needed during resection of tumors close to the artery and during repair of lacerations. We defined the anatomy of the anterior root of each transverse process (TP) from C3 to C6 for identification and exposure of the VA during the anterior approach. We examined the anatomy of the TP and assessed two approaches for safe identification of the VA, lateral to medial and medial to lateral dissection of the TP, in 20 cadavers. Read More

    Two Rare Variants of Left Vertebral Artery.
    J Craniofac Surg 2017 Feb 15. Epub 2017 Feb 15.
    Department of Anatomy, AIIMS Rishikesh, Rishikesh, India.
    Though the variations of vertebral artery are clinically asymptomatic yet abnormalities are of diagnostic importance either prior to vascular surgery in the neck region or in patients of intravascular diseases such as arteriovenous malformations or cerebral aneurysms. Therefore, the aim of the study is to bring out 2 variations in the configuration of vertebral artery and their clinical implication. During dissection of thorax of 2 female cadavers, 2 different variants of configurations of left vertebral arteries were observed. Read More

    Complicated thoraco-abdominal aortic dissection presenting with lower limb ischemia in a patient with bovine arch and arteria lusoria.
    Eur Rev Med Pharmacol Sci 2017 Jan;21(2):310-312
    Department of Visceral Surgery, and Department of Vascular Surgery; University Hospital CHUV, Lausanne, Switzerland.
    We report the case of a 58-year-old man who presented with thoraco-abdominal pain and right lower limb ischemia due to type B aortic dissection. Moreover, the patient was discovered to have several concomitant aortic arch anomalies (bovine arch, arteria lusoria, and left vertebral artery arising from the aortic arch). Taking into account this complex anatomy, emergent femoral exploration with fenestration and thrombectomy was performed. Read More

    A simple post mortem room angiography method for the investigation of traumatic basal subarachnoid hemorrhage.
    Forensic Sci Med Pathol 2017 Mar 17;13(1):4-9. Epub 2017 Jan 17.
    Forensic Pathology Unit, Department of Pathology, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK.
    Identifying the site of vascular bleeding in fatal cases of traumatic basal subarachnoid hemorrhage (TBSAH) is important, but can be very difficult to achieve when there is extensive blood clot in the posterior cranial fossa. Post mortem angiography in these circumstances has been reported previously but with mixed results, and is rarely used in current practice within the United Kingdom. We have developed a simple and effective post mortem angiography method, using fluoroscopy and clear modern contrast medium, suitable for use in the autopsy room. Read More

    Reperfusion therapy in patients with acute ischaemic stroke caused by cervical artery dissection.
    Neurologia 2017 Jan 12. Epub 2017 Jan 12.
    Servicio de Neurología, Hospital Universitario Ramón y Cajal, Departamento de Neurología, Facultad de Medicina, Universidad de Alcalá (IRYCIS), Madrid, España.
    Introduction: Cervical artery dissection (CAD) is responsible for up to 20% of all ischaemic strokes in patients younger than 45. The benefits of acute-phase reperfusion therapy in these patients have yet to be confirmed.

    Methods: We conducted a retrospective review of patients with CAD admitted to a comprehensive stroke centre between 2010 and 2015. Read More

    Progressive Bilateral Vertebral Artery Dissection in a Case of Osteogenesis Imperfecta.
    J Stroke Cerebrovasc Dis 2017 Mar 11;26(3):e43-e46. Epub 2017 Jan 11.
    Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
    A 32-year-old woman with osteogenesis imperfecta (OI) was admitted to the hospital because of a right-sided occipital headache and facial paresthesia. She was diagnosed with lateral medullary syndrome due to right vertebral artery (VA) dissection. She was treated conservatively without antithrombotic therapy. Read More

    Posterior versus Anterior Circulation Stroke in Young Adults: A Comparative Study of Stroke Aetiologies and Risk Factors in Stroke among Young Fabry Patients (sifap1).
    Cerebrovasc Dis 2017 14;43(3-4):152-160. Epub 2017 Jan 14.
    Department of Neurology, University Medicine, Ernst Moritz Arndt University, Greifswald, Germany.
    Background: Although 20-30% of all strokes occur in the posterior circulation, few studies have explored the characteristics of patients with strokes in the posterior compared to the anterior circulation so far. Especially data on young patients is missing.

    Methods: In this secondary analysis of data of the prospective multi-centre European sifap1 study that investigated stroke and transient ischemic attack (TIA) patients aged 18-55 years, we compared vascular risk factors, stroke aetiology, presence of white matter hyperintensities (WMH) and cerebral microbleeds (CMB) between patients with ischaemic posterior circulation stroke (PCS) and those having suffered from anterior circulation stroke (ACS) based on cerebral MRI. Read More

    Congenital anomaly of the posterior arch of the atlas: a rare risk factor for posterior circulation stroke.
    J Neurointerv Surg 2017 Jan 12. Epub 2017 Jan 12.
    The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
    We report an extremely rare case involving a posterior arch anomaly of the atlas, causing a vertebral artery dissection (VAD) induced posterior circulation stroke. A 16-year-old girl was admitted to hospital because of new onset dizziness. VAD related multiple infarction in the posterior circulation was revealed. Read More

    "Man in the Barrel" Syndrome with Anterior Spinal Artery Infarct due to Vertebral Artery Dissection.
    J Stroke Cerebrovasc Dis 2017 Mar 5;26(3):e41-e42. Epub 2017 Jan 5.
    Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil.
    Background: Man in the barrel syndrome (MBS) is a condition of brachial diplegia initially described after a bilateral watershed cerebral infarct between the anterior and the middle cerebral artery territories.

    Objective: To report a case of MBS as a consequence of anterior spinal artery infarct due to vertebral artery dissection.

    Discussion: More recently, nonischemic lesions in brain and brain stem have also been described as etiologies of MBS. Read More

    Surgical nuances on the treatment of giant dumbbell cervical spine schwannomas: description of a challenging case and review of the literature.
    Spinal Cord Ser Cases 2016 7;2:15042. Epub 2016 Apr 7.
    Department of Experimental Biomedicine and Clinical Neurosciences (Bionec), School of Medicine, Neurosurgical Clinic, University of Palermo , Palermo, Italy.
    We report a case of a giant intra and extradural cervical schwannoma in a patient affected by a severe myelo-radiculopathy. Clinical features, diagnosis and the issues concerning the surgical management of this benign tumor are discussed. We also review similar cases previously reported in the literature. Read More

    Congenital anomaly of the posterior arch of the atlas: a rare risk factor for posterior circulation stroke.
    BMJ Case Rep 2017 Jan 4;2017. Epub 2017 Jan 4.
    The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
    We report an extremely rare case involving a posterior arch anomaly of the atlas, causing a vertebral artery dissection (VAD) induced posterior circulation stroke. A 16-year-old girl was admitted to hospital because of new onset dizziness. VAD related multiple infarction in the posterior circulation was revealed. Read More

    Transperitoneal Intervascular Approach for Repair of the Lumbar Spine.
    Int J Angiol 2016 Dec 18;25(5):e58-e59. Epub 2015 May 18.
    Division of Vascular Surgery, Long Island Jewish Medical Center, New Hyde Park, New York.
    This report describes a novel anterior surgical approach to the midlumbar spine. A transperitoneal dissection separating the tissue planes between the infrarenal vena cava and abdominal aorta allows for ample exposure in the reconstruction of midlumbar vertebral body fractures. Read More

    Spontaneous vertebral artery dissection with multiple supratentorial and infratentorial acute infarcts in the posterior circulation Case report.
    J Med Life 2016 Jul-Sep;9(3):294-296
    "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; Romanian Society of Stroke; Neurology Department, National Institute of Neurology and Cerebrovascular Diseases, Bucharest, Romania.
    The article represents a case of a young patient with atypical clinical and paraclinical presentation of vertebral artery dissection by multiple cerebral infarcts, localized at the supratentorial and infratentorial levels in the posterior circulation. A case of a 21-year-old man, without a history of trauma in the cervical area or at the cranial level, without recent chiropractic maneuvers or practicing a sport, which required rapid, extreme, rotational movements of the neck, was examined. He presented to the emergency room with nausea, numbness of the left limbs, dysarthria, and incoordination of walking, with multiple objective signs at the neurological examination, which revealed right vertebral artery subacute dissection after the paraclinical investigations. Read More

    Correlations between the semiologic changes and the imaging aspects in the lateral bulbar infarction.
    J Med Life 2016 Jul-Sep;9(3):270-274
    "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; Romanian Society of Stroke; Neurology Department, National Institute of Neurology and Cerebrovascular Diseases, Bucharest, Romania.
    The study aimed to evaluate the correlations between the clinical and paraclinical data in the lateral bulbar infarction, benefiting from the access to the semiologic characteristics of a group studied and the MRI angiography, without a contrast agent, through the 3D TOF technique combined with MIP, as an imaging technique for the evaluation of the arterial lesion. The study group included 20 patients with lateral bulbar infarction, 14 men, and 6 women aged between 21 and 80 years, the mean age being 56, 9 years, who were enrolled in the study in the period 2012 and 2014, following the admission in the National Institute of Neurology and Neurovascular Diseases. All the patients enrolled in this stage study, performed brain MRI - in the Medinst laboratory, which included the following sequences T1, T2, Flair, DWI, MRI angiography without contrast agent (3D TOF combined with MIP). Read More

    Triple Stent Therapy for the Treatment of Vertebral Dissecting Aneurysms: Efficacy and Safety.
    World Neurosurg 2017 Mar 1;99:79-88. Epub 2016 Dec 1.
    Department of Radiology, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea. Electronic address:
    Background: There are several treatment modalities for vertebral dissecting aneurysms. The purpose of this study was to evaluate the efficacy and safety of triple stent therapy for intracranial vertebral dissecting aneurysm (VDA).

    Methods: Eight patients with 9 VDAs underwent multiple stent insertion therapy. Read More

    Hybrid Repair of Complex Left Subclavian Artery Injury with Partial Transection and Complete Thrombosis in an Unstable Patient following Blunt Trauma.
    Ann Vasc Surg 2017 Apr 27;40:298.e11-298.e14. Epub 2016 Nov 27.
    Department of Surgery, Division of Vascular Surgery, University of New Mexico, Albuquerque, NM.
    Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high-speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis. Read More

    Craniovertebral junction 360°: A combined microscopic and endoscopic anatomical study.
    J Craniovertebr Junction Spine 2016 Oct-Dec;7(4):204-216
    Department of Neurosurgery, Surgical Neuroanatomy Lab, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
    Objectives: Craniovertebral junction (CVJ) can be approached from various corridors depending on the location and extent of disease. A three-dimensional understanding of anatomy of CVJ is paramount for safe surgery in this region. Aim of this cadaveric study is to elucidate combined microscopic and endoscopic anatomy of critical neurovascular structures in this area in relation to bony and muscular landmarks. Read More

    Carotid and Vertebral Dissection Imaging.
    Curr Pain Headache Rep 2016 Dec;20(12):68
    Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
    Carotid or vertebral artery dissection is the result of a tear in the vessel lining wherein the intima separates the media. This creates a false or pseudo lumen, often accompanied by hemorrhage into the arterial wall. Dissection of these craniocervical vessels often manifests with pain alone but, if untreated, may result in severe neurologic compromise. Read More

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