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Namikawa H, Ogata A, Furukawa T, Masuoka J, Abe T. Traumatic Vertebral Artery Dissection Without Cervical Spine Injury Treated by Mechanical Thrombectomy. Cureus 2024; 16:e60287. [PMID: 38872668 PMCID: PMC11175024 DOI: 10.7759/cureus.60287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
A 59-year-old female injured in a motor vehicle accident presented with progressively impaired consciousness, and emergent magnetic resonance imaging (MRI) revealed basilar artery occlusion (BAO). Mechanical thrombectomy (MT) was performed immediately and achieved complete recanalization. Contrast-enhanced MRI also indicated right vertebral artery dissection (VAD), and the patient was subsequently diagnosed with artery-to-artery embolism caused by traumatic VAD. Anticoagulation therapy was initiated postoperatively, and there was no VAD or BAO recurrence during the three-month follow-up. This is the first reported case of BAO caused by traumatic VAD in an adult without accompanying cervical vertebral fracture treated using MT.
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Affiliation(s)
| | - Atsushi Ogata
- Department of Neurosurgery, Saga University, Saga, JPN
| | | | - Jun Masuoka
- Department of Neurosurgery, Saga University, Saga, JPN
| | - Tatsuya Abe
- Department of Neurosurgery, Saga University, Saga, JPN
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Nguyen VN, Parikh KA, Barats M, Motiwala M, Heiferman DM, Miller LE, Arthur AS, Hoit DA, Khan NR. Acute Placement of Telescoping Open Cell Stents and Thrombectomy for Progressive Symptomatic Vertebrobasilar Dissection: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2023; 24:e104-e105. [PMID: 36227182 DOI: 10.1227/ons.0000000000000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/09/2022] [Indexed: 01/18/2023] Open
Affiliation(s)
- Vincent N Nguyen
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Kara A Parikh
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Michael Barats
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Mustafa Motiwala
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Daniel M Heiferman
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Neurosurgery, Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA
| | - L Erin Miller
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Adam S Arthur
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Neurosurgery, Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA
| | - Daniel A Hoit
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Neurosurgery, Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA
| | - Nickalus R Khan
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Neurosurgery, Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA
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Kondo R, Ishihara S, Uemiya N, Kakehi Y, Nakadate M, Singu T, Tsuzuki N, Tokushige K. Endovascular Treatment for Acute Ischaemic Stroke Caused by Vertebral Artery Dissection: A Report of Three Cases and Literature Review. NMC Case Rep J 2022; 8:817-825. [PMID: 35079554 PMCID: PMC8769423 DOI: 10.2176/nmccrj.cr.2021-0268] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/20/2021] [Indexed: 11/20/2022] Open
Abstract
Vertebrobasilar artery dissection is an uncommon cause of acute ischaemic stroke (AIS). Optimal endovascular management has not been established. This study aimed to share our experience with endovascular reperfusion therapy for vertebrobasilar artery occlusion due to vertebral artery dissection (VAD). We retrospectively reviewed 134 consecutive patients with AIS who received urgent endovascular reperfusion therapy between November 2017 and November 2019. Three patients diagnosed with VAD were investigated. The evaluation included mechanisms of vertebrobasilar artery occlusion due to VAD, variations in endovascular procedures, and functional outcomes. Dissections at the V3, V4 and extension of V3 to V4 segments were seen in one patient each. The mechanism of AIS was different in each patient: occlusion of the distal non-dissected artery due to an embolus from the dissection site (distal occlusion), haemodynamic collapse of the entire vertebrobasilar artery system due to the arterial dissection itself (local occlusion), or coexistence of distal occlusion and local occlusion (tandem occlusion). The endovascular reperfusion therapy was performed corresponding to the abovementioned mechanisms: mechanical thrombectomy for distal occlusion, stenting for local occlusion, and a combination of thrombectomy and stenting for tandem occlusion. In all three patients, effective recanalization and functional independence (modified Rankin Scale scores of 0–2 at 90 days after the onset) were achieved. Endovascular treatment corresponding to the individual mechanism of AIS may improve patient outcomes.
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Affiliation(s)
- Ryushi Kondo
- Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan
| | - Shoichiro Ishihara
- Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan
| | - Nahoko Uemiya
- Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan
| | - Yoshiaki Kakehi
- Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan
| | - Masashi Nakadate
- Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan
| | - Takaomi Singu
- Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan
| | - Nobusuke Tsuzuki
- Department of Neurosurgery, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan
| | - Kazuo Tokushige
- Department of Neurosurgery, Saitama Sekishinkai Hospital, Sayama, Saitama, Japan
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