Cerebral Angiography

Publication Title: 
Clinical and Experimental Neurology

Basilar artery occlusion developed in a 34 year old woman 2 months after adopting unusual neck postures during yoga practice. On angiography, her basilar artery was filled with intraluminal clot while the vertebral arteries were normal. We postulate that a severe reduction in blood flow and possibly an intimal tear triggered thrombosis of the vertebral artery and that the final stroke mechanism was artery-to-artery embolism.

Author(s): 
Fong, K. Y.
Cheung, R. T.
Yu, Y. L.
Lai, C. W.
Chang, C. M.
Publication Title: 
The Journal of Emergency Medicine

Vertebral artery dissection has been previously reported following minor head and neck trauma. Such activities as rapid head turning, tennis, yoga, and vigorous exercise have been implicated. We report a case of vertebral artery dissection following minor neck trauma suffered in a volleyball game. The anatomy of the vertebral artery, pathophysiology of dissection, and emergency department recognition and treatment of this disorder are discussed.

Author(s): 
DeBehnke, D. J.
Brady, W.
Publication Title: 
Interventional Neuroradiology: Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences

We describe a patient with subcutaneous hematoma associated with manual cervical massage during carotid artery stenting.A 73-year-old man with left cervical carotid artery stenosis presented with left amaurosis fugax. We performed carotid artery stenting using distal embolic protection with balloon occlusion. Dual antiplatelet therapy was maintained in the periprocedural period and an anticoagulant agent was administered during the procedure.

Author(s): 
Tsurumi, A.
Tsurumi, Y.
Negoro, M.
Yokoyama, K.
Oheda, M.
Susaki, N.
Tsugane, T.
Takahashi, T.
Miyachi, S.
Publication Title: 
Neurology

We describe 4 patients ages 28 to 41 with lateral medullary infarction (Wallenberg's syndrome) following chiropractic neck manipulation. In 3 patients, angiography documented dissection of the extracranial 3rd segment of the vertebral artery near the atlantoaxial joint. The onset of neurologic symptoms following manipulation varied from immediate to 4 days. All had good recovery with minor residual deficits.

Author(s): 
Frumkin, L. R.
Baloh, R. W.
Publication Title: 
AJNR. American journal of neuroradiology

Vertebral artery dissection after neck manipulation has been well described. A case of bilateral vertebral artery dissection diagnosed with dynamic CT scanning of the neck is reported. The CT appearances and correlative angiographic and MR findings are presented.

Author(s): 
Soper, J. R.
Parker, G. D.
Hallinan, J. M.
Publication Title: 
Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine

Vertebral artery dissections (VADs) following a variety of minor traumatic mechanisms have been previously reported. This article reports 2 cases of VAD with delayed recognition following motor vehicle collisions (MVCs). The first VAD patient developed major neurologic abnormalities 28 hours after an MVC. The second VAD patient presented with 3 weeks of neck and head pain beginning 8 weeks after an MVC and subsequent chiropractic manipulation. The anatomy and pathophysiology of VAD are reviewed.

Author(s): 
Showalter, W.
Esekogwu, V.
Newton, K. I.
Henderson, S. O.
Publication Title: 
Neurologia Medico-Chirurgica

A 57-year-old male presented with a rare case of spontaneous vertebral arteriovenous fistula manifesting as radiculopathy of the right arm, subsequently associated with pulsating tinnitus and vascular bruit in the nape. He had a past history of chiropractic-induced vertebrobasilar infarction. Angiography showed a simple and direct fistula between the third segment of the right vertebral artery and the epidural veins at the C-1 level, where the artery runs backward above the arch of the C-1 just proximal to the penetration of the dura.

Author(s): 
Yoshida, S.
Nakazawa, K.
Oda, Y.
Publication Title: 
Neuroradiology

Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation.

Author(s): 
Nadgir, R. N.
Loevner, L. A.
Ahmed, T.
Moonis, G.
Chalela, J.
Slawek, K.
Imbesi, S.
Publication Title: 
Seminars in Ophthalmology

A 26-year-old woman presented with acute headache and hand-motion vision in both eyes. One day prior to presentation she went to her chiropractor for cervical manipulation. The patient had received 20 chiropractic manipulations over the previous two years. CT scan and MRI showed bilateral, symmetric occipital-parietal hemorrhagic infarctions. Angiography revealed severe focal stenosis in the distal vertebral arteries bilaterally at the superior C1 level possibly representing dissections. There was also a pseudoaneurysm of the left vertebral artery at the C1 level.

Author(s): 
Jay, Walter M.
Shah, Manan I.
Schneck, Michael J.
Publication Title: 
Neurologia Medico-Chirurgica

A 57-year-old male presented with a rare case of spontaneous vertebral arteriovenous fistula manifesting as radiculopathy of the right arm, subsequently associated with pulsating tinnitus and vascular bruit in the nape. He had a past history of chiropractic-induced vertebrobasilar infarction. Angiography showed a simple and direct fistula between the third segment of the right vertebral artery and the epidural veins at the C-1 level, where the artery runs backward above the arch of the C-1 just proximal to the penetration of the dura.

Author(s): 
Yoshida, S.
Nakazawa, K.
Oda, Y.

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