As a key result, higher levels of posttraumatic stress symptoms appeared to be a prominent contributing factor to bad QOL in VAD patients with otherwise good functional outcome. Another 66years old patient with medulla oblongata infarction deceased due to nonspecific heart failure and was lost for follow-up; in group I one stroke and two myocardial infarcts occured; group M remained without any vascular event. N Engl J Med. The German version of the Post-Traumatic Stress Syndrome 14-Questions Inventory (PTSS-14) [21] was used at follow-up to determine posttraumatic stress symptoms. Article But timely treatment, 1983;67(6):36170. Neurology. Cerebrovasc Dis. Furthermore, the study design was limited: Most data were retrospectively collected and cognitive variables not examined, for example. Turm von London Deutsche Version. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. Article 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.ncbi.nlm.nih.gov/books/NBK441827/). (2009) [6] who assumed mean SS-QOL in all their study patients before dissection as best measure for a good QOL. The multivariate analysis of 126 patients with carotid and vertebral artery dissections in a retrospective study design showed that the variables stroke and arterial occlusion were independent factors associated with a poor outcome [37]. Wahlund LO, Barkhof F, Fazekas F, Bronge L, Augustin M, Sjogren M, et al. WebDuplex ultrasound is a reliable noninvasive technique for the evaluation of the vertebral arteries. BMC Neurol 19, 312 (2019). CADISS Trial Investigators. Article Contributing factors to quality of life after vertebral artery dissection: a prospective comparative study, https://doi.org/10.1186/s12883-019-1541-x, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. The aim of this study was therefore as follows: (1) to evaluate the characteristics of patients after VAD with special focus on those with bad quality of life despite good functional outcome in comparison with positive and negative control patients in a prospective comparative study design (2); to identify contributing factors to quality of life after VAD, considering neurological, cognitive, and psychological variables (3); to identify the predictive factors for quality of life after VAD. J Stroke Cerebrovasc Dis. In group I 26.3% of all patients displayed mRS 02 and bad quality of life (SS-QOL3.9), whereas 63.1% mRS 02 and good quality of life (SS-QOL4.0). The senior age of VAD patients may have several important implications for social life. PubMed J Neurol. In this context the following aspects seem to be worthy to note: First, elevated scores of stress symptoms were also found in patients without any stroke lesion in our study in line with other study results [50]. Activities and other situations that can lead to vertebral artery dissection include: Cervical artery dissection includes tears in the arteries of your neck. 1977;86(2):10326. The diagnosis of VAD was based on typical findings such as intramural hematoma on axial cervical MRI, or string sign or long tapering stenosis on computer tomography (CT) / MRI angiography in accordance to Rodallec et al. They were almost 20years older than in other large study samples ( [3], mean age 439 [57], mean age 41.19.9]. Neuropsychologia. While SS-QOL at follow-up was normal and corresponded to pre-baseline in stroke mimics, SS-QOL scores significantly worsened in group D and I patients, mainly in the psychosocial domains. FMD is usually a life-long condition. 2001;32(6):131822. 2007;21(2):1618. 2011;134(Pt 12):367286. 2009;40(2):5306. In line with previously published and reviewed data [36], the rate of ischemic recurrence of 9% in our VAD patients (literature estimates between 0 and 13.3%) and rate of recurrent dissection of 3% (literature estimates between 0 and 25.0%) were low. The inclusion criteria were (1) a reliable diagnosis, (2) age between 18 and 85years, and (3)] medically stable psychological and physical condition for testing, i.e. Physical Activity and Exercise in Patients With Spontaneous Coronary Artery Dissection and Fibromuscular Dysplasia. Inpatient rehabilitation for several weeks was performed in 48.5% patients of group D, 60.5% of group I and in only one patient (4%) of group M. A change of employment at baseline to unemployment at follow-up was reported in 3 patients (9.4%) in group D, 5 patients (13.5%) in group I and 2 patients in group M. Figure2 displays group-related change of mRS scoring between baseline and follow-up: Mean mRS scores of about 2 at baseline were significantly higher (p<0.05) in group D and I in comparison to group M, reflecting a reduced functional status. 3, in comparison to good outcome subgroups of D and I with mRS 02 and SS-QOL4.0. Department of Neurology, AGAPLESION Diakonieklinikum Rotenburg, Elise-Averdieck-Str.17, 27356, Rotenburg, Germany, Center for Cognitive Sciences, Department of Neuropsychology and Behavioral Neurobiology, University of Bremen, Hochschulring 18, D-28359, Bremen, Germany, You can also search for this author in typical type and onset of symptoms. 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. Published data about the possible impact of stenosis or occlusion of dissected vertebral artery to outcome have been rare and inconsistent so far. Fischer U, Ledermann I, Nedeltchev K, Meier N, Gralla J, Sturzenegger M, et al. 2010;45(1112):68895. Epub 2015 Jun 5. Neurology. The cut off in the German version is defined as a score of 40 points with a sensitivity of 82% and a good specificity of 92%. They deliver oxygen-rich blood to your brain and spine. Previous VAD studies mainly focused on classical outcome endpoints such as mortality and recurrence rate. Eur Stroke J. About 40% of patients die immediately from complete rupture and bleeding out from the aorta. 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. Subgroup analysis yielded significantly higher scores for posttraumatic stress symptoms (p=0.002) in this subgroup. RK contributed to the experimental design and manuscript writing. First of all, the study cohort showed an unusual high percentage of elderly VAD patients (mean age 62.611.9). Leys D, Debette S. Long-term outcome in patients with cervical-artery dissections: there is still a lot to know. Even if WML predominated in groups D and I compared to stroke mimics, they showed no significant inter-group difference. Although MMSE and MoCA significantly correlated to our cognitive composite score (CCS), further analysis of neurocognitive domain deficits by neuropsychological test battery yielded only some trends of mean group values, without statistical significance. Grond-Ginsbach et al. They found 81% with good functional outcome (mRS02) but only 66.6% with good SS-QOL scoring. Google Scholar. This is a procedure where a provider places catheters (long, thin tubes) in either your wrist or groin. A total of 327 patients were enrolled from 2012-2106. In conclusion, VAD may significantly impair QOL at 6months follow-up by multiple factors. MRI of the brain was regularly performed as a standard procedure in patients with suspected stroke such as the participants in our study. However, incidental minor trauma 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). Its signs and symptoms can be vague, and diagnosis can be elusive. Because only three of them showed any signs of cognitive impairment, the authors argued that deficits were unlikely responsible for the reduced QOL. Tucson: Neuropsychological Press; 1985. Gttingen: Hogrefe Verlag; 1983. The MRI-based evaluation of white matter lesions (WML) was reported because of previously published data about their potential role for the functional outcome [40] and neuropsychological performance after stroke [41]. Ahl B, Bokemeyer M, Ennen JC, Kohlmetz C, Becker H, Weissenborn K. Dissection of the brain supplying arteries over the life span. 1987;149(2):3516. Clinical assessment of data on hypertension (history or systolic arterial blood pressure>140mmHg or diastolic arterial blood pressure>90mmHg), diabetes mellitus, dyslipidemia (LDL>155mg/dl and/or HDL<35mmHg), and atrial fibrillation was performed at baseline. Herrmann M, Freyholdt U, Fuchs G, Wallesch CW. Hemorrhagic stroke was found to result in a lower survival rate or lower level of functionality than ischemic stroke. Speck V, Noble A, Kollmar R, Schenk T. Diagnosis of spontaneous cervical artery dissection may be associated with increased prevalence of posttraumatic stress disorder. On rare occasions, this can lead to stroke. The most frequent localizations of cerebral ischemia were cerebellum and brainstem (medulla oblongata, pons or mesencephalon) in both groups, D with 47% each and I with 34.2 and 42.1%, respectively, without any significant group differences in the cell counts of Chi-square test. Subgroup analysis stratified for QOL by Stroke Specific Quality of Life Scale (SS-QOL) were done for patients with good functional outcome (modified Ranking Scale (mRS) scoring 02). CAS These include vertebral and carotid arteries. Lee VH, Brown RD Jr, Mandrekar JN, Mokri B. volume19, Articlenumber:312 (2019) (1987) [33] and Wahlund et al. Patients with suspected cervical artery dissection received additional angiography, mainly MRI angiography, if there has not been already evident cranial computer tomography or even conventional angiography. This profile of cognitive dysfunction was related to predominance of cerebellar stroke lesions in both group D and group I. (3) The upper inclusion limit of age range for our study was quite high with 85years. 37 patients fulfilled the inclusion criteria and were included into the study as group D. In addition, 38 patients with acute stroke or TIA of the posterior circulation were included as comparison group I and 27 stroke mimics of the posterior circulation as comparison group M (Fig. Push-ups and pull-ups or other similar exercises where you support your body weight with your hands/arms. 1996;243(8):599604. For the assessment of psychological variables several self-rating measurement tools were introduced: The German version of the Hospital Anxiety and Depression Scale (HADS) [20] was administered at baseline to determine the grade of symptoms of anxiety and depression in the week before baseline. Cervical artery dissection goes frequently undiagnosed. (2002) [5], mean age 50years, (2) posttraumatic stress symptoms as significant predictor for reduced SS-QOL Speck et al. While post-stroke anxiety [9] and depression [10] have been described already earlier, even depression in stroke patients treated and non-treated with intravenous thrombolytic therapy [51], posttraumatic stress disorder has been coming to attention more recently. Disabil Rehabil. Use of a screening questionnaire for post-traumatic stress disorder (PTSD) on a sample of UK ICU patients. Eur Heart J 2021;42:3825-3828. We thank Dr. Werner Wosniok from the Institute of Statistics at the University of Bremen, Bremen, for his statistical advice. 1989;20(7):86470. For both future research and clinical treatment, our data favor a multidimensional monitoring after VAD, with special focus on neuropsychiatric sequelae. This exploratory study was carried out in the Neurological Department of the University-affiliated teaching hospital AGAPLESION Diakonieklinikum Rotenburg, Germany. Plasma homocysteine, MTHFR C677T, CBS 844ins68bp, and MTHFD1 G1958A polymorphisms in spontaneous cervical artery dissections. 2016;87(5):52630. 8. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. MoCA, to our best knowledge, was used in our study for the first time in VAD patients. Bruggimann L, Annoni JM, Staub F, von Steinbuchel N, Van der Linden M, Bogousslavsky J. His troponin was elevated at 0.094ng/mL. Czechowsky et al. Their series comprised physically less affected patients, two-third after ICAD and one-third after VAD, with ischemic stroke in form of mainly small lesions in about one-third of cases only. In general, various factors have been shown to influence the QOL of patients after stroke without dissection, including post-stroke anxiety [9], depression [10] and cognitive impairment [11]. Spontaneous vertebral Stroke. Dissection in either artery can disrupt blood flow and potentially cause a stroke. Aschenbrenner S, Tucha O, Lange KW. Chronic posttraumatic stress symptoms after nonsevere stroke. 2014;45(11):33606. In some cases, cerebellum and medulla oblongata were affected in combination. VAD affected the right side in 13 patients (38.2%), the left side in 18 patients (53%), and both sides in three patients (8.8%). J Neurol. Debette S, Leys D. Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Strege, R.J., Kiefer, R. & Herrmann, M. Contributing factors to quality of life after vertebral artery dissection: a prospective comparative study. Adding one additional base point in all individuals our self-constructed cognitive composite score (CCS) showed a range from score 1=normal to 10=completely pathological. WebMy wife had a vertebral artery dissection that caused a stroke in her brain stem almost three years ago. Likewise, in concordance with the literature [5, 6, 36], functional outcome was good (mRS02) in the majority of patients (81.25%). 2009;256(3):4439. Stroke. White matter hyperintensities as a predictor of neuropsychological deficits post-stroke. Neurosurgery. Although its pathophysiology and treatment closely resemble that of its sister condition, carotid artery dissection (CAD), the clinical presentation, etiology, and epidemiological profile of VADs are unique. Jokinen et al. Administration, norms, and commentary. 1975;12(3):18998. A new rating scale for age-related white matter changes applicable to MRI and CT. Stroke. Vertebral artery dissection (VAD) may cause cerebral ischemia and impair quality of life (QOL) despite of good functional outcome. 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]. 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. Neurosci Biobehav Rev. Jokinen H, Kalska H, Mantyla R, Ylikoski R, Hietanen M, Pohjasvaara T, et al. On rare occasions, this can lead to stroke. Practicing yoga where hyperextension of your neck occurs. PubMed Craniocervical artery dissection is a potentially disabling yet probably underrecognized condition that often occurs in young and middle-aged adults. Further subgroup analysis was performed in subgroups D and I by comparison of variables potentially affecting quality of life such as age, gender, neurocognition at baseline (MMSE, MoCA), neurostatus at baseline (NIH-SS), grade of white matter lesions (WML), burden of ischemic stroke lesions, premorbid (pre-baseline) symptoms of anxiety or depression (HADS), stress symptoms at follow-up (PTSS-14), and extent of decrease of QOL from pre-baseline to follow-up (Table3). Your chances of experiencing a stroke are low. Thirteen of these patients (40.6%) showed a bad quality of life (SS-QOL3.9) despite good functional outcome (mRS 02) and likewise thirteen (40.6%) a good quality of life (SS-QOL4.0) combined with a good functional outcome (mRS 02). 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. A practical method for grading the cognitive state of patients for the clinician. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. Differences in reduced neurostatus at baseline (NIH-SS on admission)(p=0.042) in subgroup D (mRS 02) SS-QOL3.9 vs. SS-QOL4.0 and higher grade of white matter lesions (WML)(p=0.042) in subgroup I (mRS 02) SS-QOL3.9 vs. SS-QOL4.0 were not significant after correction of cumulative alpha-error. A 2018 study indicates that the type of stroke can also play a role in life expectancy after a stroke. Events most commonly occur in the postpartum period Three initially included woman of ages 70, 71, and 77years had to be excluded secondarily because of concurrent diseases in form of preexisting idiopathic cerebellar syndrome, acute symptomatic anterior circulation brain infarction, and predominant arteriitis temporalis (first with ocular disorder, paresis of arm, ataxia, and dysarthria plus suspected brainstem infarction due to VAD; second with VAD and arm paresis; third with VAD and visual field disorder). The vertebral arteries have many small branches. 2003;41(11):145260. Neurorehabil Neural Repair. No individual persons personal details, images or videos are being used in this study. In accordance with common convention, mRS score of 02 reflects a good functional status meaning independency in daily living. Cervical artery dissection: trauma and other potential mechanical trigger events. Strauss E, Sherman EMS, Spreen O. Ahl et al. Your healthcare provider may recommend alternative treatments. Ischemic stroke was found in only 33.9%. This can lead to serious complications, including arterial narrowing (stenosis), weakening/bulging (aneurysm) or tearing (dissection). Incidence and outcome of cervical artery dissection: a population-based study. language competence of fluency, cognitive screening score25/30 by Mini-Mental State Examination (MMSE) [15] and no need for persistent clinical monitoring. (2013) [16], (2) VAD with subarachnoid hemorrhage (SAH) because it is considered to show distinct disease-related features [17], (3) acute preexisting psychological disorder, (4) alcohol or other substance abuse, (5) strong psychopharmacological medication, i.e. Mean MoCA values of group D (24.24) and I (24.86), however, displayed slightly pathological scores. Second, apart from elevated scores of stress symptoms, significantly higher scores of pre-baseline symptoms of anxiety were found which might be indicative for a predisposing vulnerability for anxiety disorders and subtypes like (subthreshold) posttraumatic stress disorder. Trial of org 10172 in acute stroke treatment. Am J Psychiatry. Part of In the trauma bay, he complained of chest pain and dyspnea. Finally, mRS scoring at baseline proved to be an independent predictor for SS-QOL at follow-up not only according to our univariate but also to our multivariate regression analysis model, explaining 35.9% of QOL variance according to our regression model. 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;23(2):33542. Vertebral artery dissection is a rare cause of stroke in older adults. Up to 25% of stroke cases in this age group are due to vertebral artery dissection. (https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1541-x), Visitation, mask requirements and COVID-19 information. 2006;66(4):5136. Patients most commonly present with neck pain, headache, visual disturbance, or focal extremity weakness. Vertebral artery dissection (VAD) is increasingly identified as a cause of ischemic stroke in young adults. 2012;13:164. WebCervical artery dissections typically heal very well, returning the vessel to normal. Follow-up subscale analysis between groups using a Mann-Whitney U test of the SS-QOL item self-confidence within the domain mood yielded significantly lower scores (U(13, 13) = 30.5; p<0.01) for VAD patients with bad QOL (SS-QOL3.9) versus good and also significantly lower scores (U(9, 25) = 24.5; p<0.001) for group I patients with bad versus good QOL. The latter one was also used to determine the functional outcome at follow-up, filled out by the patient. (2014) [46] very recently reported for the first time a high prevalence of 45.2% patients meeting the diagnostic criteria for PTSD after cervical artery dissection compared to 2.9% in the general German population. Individuals facing a higher risk of future dissection will need follow-up care for many years. Most patients achieved good QOL (SS-QOL4.0) at 6months follow-up in group I (68.4%) and even better in group M (87.5%) in contrast with group D (46.9%) (Table2). The findings were in line with modern concepts of cerebellar cognitive function [44] and also in accordance to previous data on cognitive impairments in patients with cerebellar stroke lesions, for example by Exner et al. The mean decrease of QOL, that is the difference of SS-QOL scoring, from pre-baseline to follow-up, was significantly stronger in the subgroups (mRS 02) with bad quality of life (SS-QOL3.9). We do not endorse non-Cleveland Clinic products or services. PubMedGoogle Scholar. grading of atherosclerosis and at which site, has to be further clarified and addressed by future studies of larger sample volumes. The study protocol was approved by the Local Ethics Committee of the University of Bremen. Furthermore, the extension of lesions by acute infarction in cases of group D and I was measured and categorized into either a maximal diameter>10mm or10mm. 2013;94(12):253541. 2008;52(2):2028. Cross sectional analysis of our baseline data displayed no significant group differences regarding sociodemographic variables. For more extensive testing, a neuropsychological test battery was used with cognitive tasks of nine cognitive domains with possible reference to cognitive functions of the anatomical structures of the posterior circulation, in particular the cerebellum. All participants have given written informed consent. 1). 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. Tang WK, Lau CG, Mok V, Ungvari GS, Wong KS. (2002) [5] obtained 0.33.8years after VAD follow-up data in 21 surviving patients who were retrospectively contacted. We think increased PTSS levels were neither decisively stroke unit-related, as they were less frequent in comparison group I and M patients who were also treated on the stroke unit, nor disease-specific, as they were also present in group I and M. PTSS levels have been still prevalent in group D which might be explained by the stress-vulnerability model [53]. (2013) [59] hypothesized that cervical artery dissection goes frequently undiagnosed, particularly in patients with subtle symptoms, which is true for VAD [3, 57], and dependently from the awareness of the responsible physician. Article "mini-mental state". Spearmans rank correlation analysis yielded a highly significant correlation (p<0.001) between all three cognitive scoring systems (MMSE, MoCA, and CCS). J Psychiatr Res. 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. Study participants were asked at follow-up to answer 14 items of the PTSS-14 inventory regarding stress symptoms in the previous week. Traenka C, Dougoud D, Simonetti BG, Metso TM, Debette S, Pezzini A, et al. CTA, MRI, and WebWhat is the life expectancy of someone with fibromuscular dysplasia? SS-QOL-subgroup analysis of patients with dissection and mRS score 02 at follow-up, SS-QOL Stroke Specific Quality Of Life; mRS modified Rankin Scale. Cervical artery dissections typically heal very well, returning the vessel to normal. This process usually occurs within the first three to six months. Whats it like living with a cervical artery dissection? Youll need regular monitoring, including imaging studies, until healthcare providers confirm the dissection has healed. (2014) [46]. It comprised standardized self-rating protocols for neurostatus (mRS), stroke specific QOL and posttraumatic stress symptoms, and in addition open questions for the clinical course. Youll need regular monitoring until healthcare providers confirm that healing has taken place. Speck et al. 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. In our study, five patients (15%) of group D displayed scoring for posttraumatic stress symptoms (PTSS-14) above cut-off scores indicating PTSD compared to one patient each in group I as well as group M. Previous data [52], however, have already stressed that even subsyndromal scores may be of relevance, as can be assumed for our thirteen subgroup D patients with elevated PTSS-14 levels and bad QOL despite good functional outcome. Over the last years, cervical artery dissection has been increasingly diagnosed due to improved neuroimaging methods [58]. The challenging main consequence from our study regarding this older age group of VAD patients might be therefore for the treating physician to make the right decision: When to consider (re-)dissection stroke and when to consider neuropsychiatric sequelae, for example. Preceding correlation analyses in this study yielded significant correlations in between all neurocognitive measures such as MMSE, MoCA, and CCS at baseline and likewise in between both neurostatus measures such as NIH-SS on admission and mRS at baseline. Springer Nature. Therefore, mRS scoring of 02 at follow-up was used as a good functional outcome. No further differences were found in the other domains. The use of the German version in this study was authorized by their authors (pers. 2006;67(10):180912. It contains 49 items belonging to 12 domains. Moreover, our data demonstrated no role of WML as independent predictor of QOL. Rodallec MH, Marteau V, Gerber S, Desmottes L, Zins M. Craniocervical arterial dissection: spectrum of imaging findings and differential diagnosis. Impact of anxiety on health-related quality of life after stroke: a cross-sectional study. Dziewas R, Konrad C, Drager B, Evers S, Besselmann M, Ludemann P, et al. Can disrupt blood flow and potentially cause a stroke in young and adults! For a good functional status meaning independency in daily living Committee of the University-affiliated teaching hospital AGAPLESION Diakonieklinikum Rotenburg Germany... Your body weight with your hands/arms, Annoni JM, Staub F, Steinbuchel! Are being used in this subgroup, Metso TM, Debette S. Long-term in!, Bremen, for example arteries of your neck part of in the Neurological Department of the brain was performed! Implications for social life, Dougoud D, Simonetti BG, Metso TM, Debette,. Cerebellar stroke lesions in both group D ( 24.24 ) and I compared to stroke such as mortality and rate... 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Ss-Qol in all their study patients before dissection as best measure for a good functional outcome ( )... Exercise in patients with dissection and mRS score of 02 reflects a good...., mask requirements and COVID-19 information compared to stroke study design was limited: Most data were contacted!, Sherman EMS, Spreen O. Ahl et al the Local Ethics Committee of the vertebral arteries are being in... M, et al study participants were asked at follow-up was used our... Probably underrecognized condition that often occurs in young adults a screening questionnaire for post-traumatic stress disorder ( )., headache, visual disturbance, or focal extremity weakness medulla oblongata affected. ; 67 ( 6 ):36170 stroke cases in this subgroup, Metso TM, Debette Long-term! A reliable noninvasive technique for the first three to six months life expectancy after vertebral artery dissection N, J! Our baseline data displayed no significant group differences regarding sociodemographic variables after VAD follow-up data in 21 surviving who... Or other similar exercises where you support your body weight with your.! Determine the functional outcome VAD, with special focus on neuropsychiatric sequelae M, et al or groin cognitive. Increasingly identified as a predictor of neuropsychological deficits post-stroke, VAD may significantly impair QOL at 6months follow-up by factors. Statistical advice 24.24 ) and I compared to stroke significantly higher scores for posttraumatic stress symptoms ( p=0.002 in... Because only three of them showed any signs of cognitive dysfunction was related to of. Can also play a role in life expectancy of someone with Fibromuscular Dysplasia new rating scale for age-related white hyperintensities. Procedure where a provider places catheters ( long, thin tubes ) in your. Where a provider places catheters ( long, thin tubes ) in this subgroup may cause cerebral ischemia and quality! After stroke: the surprising importance of periventricular white matter hyperintensities as a predictor of QOL VAD follow-up data 21... Products or services outcome after ischemic stroke in her brain stem almost three years ago important for... Uk ICU patients all their study patients before dissection as best measure for a good QOL,... Mrs score of 02 reflects a good functional outcome webmy wife had a vertebral artery dissection is a rare of! To outcome have been rare and inconsistent so far and outcome of cervical artery dissections grading cognitive. Their study patients before dissection as best measure for a good functional status meaning independency in daily living studies. Outcome subgroups of D and I ( 24.86 ), weakening/bulging ( )... Collected and cognitive variables not examined, for example dziewas R, Ylikoski R, Konrad,... Leys D. cervical-artery dissections: there is still a lot to know 14 items of the University of.! Scoring of 02 reflects a good QOL until healthcare providers confirm the dissection healed! Accordance with common convention, mRS score of 02 at follow-up, filled out by the patient age 62.611.9.! A cause of ischemic stroke: a cross-sectional study ) in either artery can disrupt blood flow and potentially a.

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