PubMedGoogle Scholar. [43] who preoperatively examined patients with cerebellar hematomas or brain tumors by the same neuropsychological tests apart from not using LPS as we did. A 42-year They argued that a systematic follow-up of the vascular lesions may induce anxiety both in patients and physicians and lead to inappropriate treatments. Neurosci Biobehav Rev. Coil Embolization for the Treatment of Ruptured Dissecting Vertebral Aneurysms. CADISS Trial Investigators. (2002) [5] obtained 0.33.8years after VAD follow-up data in 21 surviving patients who were retrospectively contacted. Regensburger Wortflssigkeitstest. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. J Clin Neurol. WebScore: 4.2/5 (61 votes) . 2003;250(10):117984. Elevated levels of posttraumatic stress symptoms, as evaluated by PTSS-14 scoring in our study, are in line with recent reports on the prevalence of posttraumatic stress disorder (PTSD) after stroke, even after minor stroke [49] or transient ischemic attack [50]. Aschenbrenner S, Tucha O, Lange KW. Kissela et al. Cerebral ischemia in group I patients was caused by cardiac embolism in 34.2%, lacunar disease in 21%, large artery disease in 10.5% and by undetermined cause in 34.2% according to the TOAST-criteria [14]. On rare occasions, this can lead to stroke. Arch Phys Med Rehabil. Acta Psychiatr Scand. Cervical artery dissection goes frequently undiagnosed. Tang WK, Lau CG, Mok V, Ungvari GS, Wong KS. You may also need to continue taking a blood thinner during this time. In the most severe cases, vertebral artery dissection causes stroke: In some people, vertebral artery dissection occurs for no known reason. It generates 12 domain-related scores and a total score. Chien C, Chang FC, Huang HC, Tsai JY, Chung CP. FMD is usually a life-long condition. Mean MoCA values of group D (24.24) and I (24.86), however, displayed slightly pathological scores. The cumulative survival rate among all types of stroke in this study was found to be 48% at five years. Consequently, a valid and reliable evaluation of this variable as putative contributing factor appeared to be not adequately possible in our study: Besides the sample size being very small, it remains unclear how to operationalize best the vascular measurements such as (1) determination of grade/severity of stenosis and by which method (MRI or ultrasound), (2) length of stenosis or occlusion, or (3) site of stenosis (unilateral left or right, bilateral, additionally extra-vertebral). Plasmin degrades fibrin, fibrinogen, and procoagulant factors V and VIII Serum half-life is 4-6 min but half-life lengthened when bound to fibrin in clot. Aortic dissection is life-threatening. In multivariate regression analysis only MMSE remained a poor predictor for QOL, explaining 12.6% of its variance. Previous studies described poststroke cognitive decline by global cognitive screening such as MMSE and more recently and more sensitively by MoCA [42]. typical type and onset of symptoms. Monitoring typically includes magnetic resonance angiography every three to six months. It can affect blood flow, putting you at risk for life-threatening complications. The finding of more neurocognitive impairments in form of lower mean values in cognitive measures in patients with ischemic lesions of both group D and group I patients did not reach significance. Plank position (but otherwise safe to participate in yoga or Pilates). Five patients were excluded from the dissection study group after screening according to the inclusion/exclusion study criteria: One woman (70years old; ataxia, dizziness, facial weakness; medulla oblongata infarction by vertebral artery occlusion suspicious for but not yet proven dissection) deceased due to unexpected cardiopulmonary failure not otherwise specified in the acute phase. Gttingen: Hogrefe Verlag; 2000. Google Scholar. Although there was a preponderance of atrial fibrillation in group I, no significant group differences of neurovascular risk factors were found in line with current knowledge about VAD characteristics [3, 35]. Vertebral artery dissection (VAD) is a rare cause of stroke in the general population; however, represents one of the more common causes of stroke in patients younger than 45 years of age. Apart from the limits of our measurement method, we assumed that the neuroanatomical function of the affected stroke area was much more important than the extension. Their high PTSD prevalence might be overestimated because physically less affected people voluntarily participating in their study might have tended to mention more mental problems when asked by self-rating PDS. Psychological self assessment for symptoms of depression (HADS-D/D), symptoms of anxiety (HADS-D/A), and posttraumatic stress symptoms (PTSS-14) showed significantly positive correlations in all groups. 2010;17(2):21925. This may also refer to some of the older patients in our study though we have not examined them for arteriosclerosis in such detail. Data about pathological results of neuropsychological test battery assessment. 2012;13:164. Subgroup analysis yielded significantly higher scores for posttraumatic stress symptoms (p=0.002) in this subgroup. 2018;3(1):4756. With carotid dissection, the dissection rarely goes completely through the artery due to its elastic outer layers. Symptomatic intracranial vertebral artery atherosclerotic stenosis (>/=70%) with concurrent contralateral vertebral atherosclerotic diseases in 88 patients treated with the intracranial stenting. In some cases, cerebellum and medulla oblongata were affected in combination. Fischer et al. Participants were examined for psychological, cognitive and neurological variables with special reference for functional outcome as well as quality of life 6months after the index event. Knecht S, Rossmuller J, Unrath M, Stephan KM, Berger K, Studer B. Med Hypotheses. 2011;134(Pt 12):367286. Google Scholar. Incidence and outcome of cervical artery dissection: a population-based study. Eur Heart J 2021;42:3825-3828. grading of atherosclerosis and at which site, has to be further clarified and addressed by future studies of larger sample volumes. Noble et al. Schievink WI. Lee VH, Brown RD Jr, Mandrekar JN, Mokri B. Previous VAD studies mainly focused on classical outcome endpoints such as mortality and recurrence rate. The main findings were found in subgroup D (mRS 02) with bad QOL3.9 that were significantly higher mean values for premorbid anxiety symptoms (p=0.006) and stress symptoms at follow-up (p=0.002). (2009) [6]. 2008;28(6):171128. When tics cause (2) Broad neuroimaging of cervical arteries including cervical MRA was regularly applied to patients of all age groups and risk profiles whenever differential diagnosis of VAD appeared to be possible. Because previous studies have shown no crucial role of neurovascular risk factors or sociodemographic factors for QOL of VAD patients, we focused our analysis of potential contributing factors for QOL on previously less investigated neurological, neurocognitive and psychological variables with special respect to the biopsychosocial model [12]. Because of the great Koolhaas JM, Bartolomucci A, Buwalda B, de Boer SF, Flugge G, Korte SM, et al. 2008;63(6):1095104 discussion 04-5. In our study, there was a trend in patients with good functional outcome (mRS score 02) to higher association of occlusion/subtotal occlusion with worse QOL, though this was statistically nonsignificant (p<0.05). Spontaneous dissection of the carotid and vertebral arteries. The hospital anxiety and depression scale. Among 24 stroke mimics only two patients (8.3%) with mRS 02 reported a bad quality of life in contrast to 20 patients (83.3%) with mRS 02. Eur J Neurol. BMC Neurol 19, 312 (2019). 2009;8(7):66878. A summary score of 4.0 was considered to indicate good QOL, a score3.9 bad QOL in accordance with Fisher et al. 2006;37(10):2499503. 2004;63(11):21325. Any activities that could result in whiplash injury or extended periods of hyperextension of your neck. Bonita R, Beaglehole R. Recovery of motor function after stroke. (2018) [38] reported more recently in their observational cohort study on patients with cervical, mainly carotid artery dissection, that numerically, but not statistically significant more patients with combined endovascular therapy (EVT)/intravenous thrombolysis (IVT) had excellent outcome and arterial recanalization than patients treated with EVT only. Likewise, mean values of pre-baseline total QOL were not significantly different. Engelter ST, Grond-Ginsbach C, Metso TM, Metso AJ, Kloss M, Debette S, et al. Intra-arterial dose: 0.3 mg/kg; not to exceed 10-20 mg . Thus, the present investigation has to be characterized as an explorative study. J Abnorm Psychol. Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. Coping with chronic neurological impairment: a contrastive analysis of Parkinson's disease and stroke. Practicing yoga where hyperextension of your neck occurs. Multimodal assessment was performed for clinical, neurological, cognitive, psychological and radiological data at baseline and for QOL, functional outcome, and stress symptoms by questionnaire at six months follow-up. Cervicocerebral artery dissection (CAD) is an important and under-recognized cause of strokes in young and middle-aged patients. 2005;76(9):122933. (2004) [58] proposed the term of atherosclerotic dissection for certain cases. A better understanding of clinical courses and their affecting variables with special respect to the biopsychosocial model [12] seemed to be of great importance for the neurorehabilitation of such VAD patients in the future. The subgroup of patients with good functional outcome (mRS score2) and bad SS-QOL score (3.9) comprised ten patients with arterial occlusion or subtotal occlusion versus three with or without stenosis. 2014;45(11):33606. In this interview, Amy Wells talks candidly about her stroke and how life has changed for the better in the The following are key points to remember from this Viewpoint article on physical activity and exercise in patients with spontaneous coronary artery dissection (SCAD) and fibromuscular WebThe vertebral arteries are part of the circulatory system. Thus, reduced neurocognition and neurostatus at baseline and increased scoring levels for stress symptoms at follow-up were predictive for reduced quality of life at follow-up in patients with VAD in this regression model. Other important findings were found in subgroup I (mRS02) with bad QOL that were significantly higher mean values for premorbid anxiety symptoms (p=0.002) and depression symptoms (p<0.001). J Neurol Neurosurg Psychiatry. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Hrting C, Markowitsch HJ, Neufeld H, Calabrese P, Deisinger K, Kessler J. WMS-R. Wechsler Gedchtnistest revidierte Fassung. A Spearmans rank correlation analysis was performed for outcome-relevant variables. Sixteen patients (47%) presented with vertigo or dizziness as either the only symptom or among other symptoms. Cervical artery dissection: trauma and other potential mechanical trigger events. 2011;92(5):7928. Webcoronary artery dissection is a potential life-threatening complication of blunt chest trauma. 2013;80(6):78790. Three cohorts of consecutive patients were included in the study for the purpose of comparison: group D (dissection) as the main group comprised patients with first-time spontaneous vertebral artery dissection (VAD) of at least one vertebral artery, group I (ischemia) as a positive control group consisted of patients with acute cerebral ischemia such as stroke or transient ischemic attack (TIA) of the posterior circulation due to any other cause than dissection, and group M (mimics) was chosen as a negative control group of stroke mimics of the posterior circulation.
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