Vertebral artery

About: Vertebral artery is a research topic. Over the lifetime, 7366 publications have been published within this topic receiving 133239 citations.

Spontaneous dissection of the carotid and vertebral arteries.

Abstract: When a tear occurs in one of the major arteries in the neck and allows blood to enter the wall of the artery and split its layers, the result is either stenosis or aneurysmal dilatation of the vessel. This process was long thought to be a rare cause of stroke, particularly in the absence of trauma, and the diagnosis was usually not made until the postmortem examination.1–3 It was not until the late 1970s, when Fisher et al.1 and Mokri et al.2 described dissections of carotid and vertebral arteries as detected by modern diagnostic approaches, that dissections began to . . .

Reversal of Blood Flow through the Vertebral Artery and Its Effect on Cerebral Circulation

Abstract: WE have recently studied 2 patients with symptoms of cerebral ischemia in whom a reversal of blood flow through the left vertebral artery was demonstrated. In both cases the anatomic lesion producing the reversal of blood flow was a stenosis of the left subclavian artery proximal to the origin of the vertebral artery. The cause of the reversed flow in these circumstances can be attributed to a fall of pressure distal to the stenosis below that at the vertebral-basilar junction so that the pressure gradient in the vertebral artery is reversed. We had not previously encountered this phenomenon and were . . .

Radiological and anatomical evaluation of the atlantoaxial transarticular screw fixation technique

Abstract: ✓ Sixty-one patients treated with C1–2 transarticular screw fixation for spinal instability participated in a detailed clinical and radiological study to determine outcome and clarify potential hazards. The most common condition was rheumatoid arthritis (37 patients) followed by traumatic instability (15 patients). Twenty-one of these patients (onethird) underwent either surgical revision for a previously failed posterior fusion technique or a combined anteroposterior procedure. Eleven patients underwent transoral odontoidectomy and excision of the arch of C-1 prior to posterior surgery. No patient died, but there were five vertebral artery (VA) injuries and one temporary cranial nerve palsy. Screw malposition (14% of placements) was comparable to another large series reported by Grob, et al. There were five broken screws, and all were associated with incorrect placement. Anatomical measurements were made on 25 axis bones. In 20% the VA groove on one side was large enough to reduce the width of the C-2 pe...

Incidence and outcome of cervical artery dissection: a population-based study.

Abstract: Background: Incidence rates for internal carotid artery dissection (ICAD) have been reported to be 2.6 to 2.9 per 100,000, but reliable epidemiologic data for vertebral artery dissection (VAD) are not available. Objective: To determine the incidence rate of cervical artery dissection (CAD) in a defined population. Methods: With IRB approval, we used the medical record linkage system of the Rochester Epidemiology Project to identify all patients diagnosed with spontaneous ICAD and VAD for the period of 1987–2003 in Olmsted County, MN. Results: Of 48 patients with CAD, there were 32 patients with ICAD and 18 patients with VAD. In Olmsted County, the average annual incidence rate for ICAD was 1.72 per 100,000 population (95% CI, 1.13 to 2.32) and for VAD 0.97 per 100,000 population (95% CI, 0.52 to 1.4). The average annual incidence rate for CAD was 2.6 per 100,000 population (95% CI, 1.86 to 3.33). The most frequently encountered symptoms in CAD were head or neck pain (80%), cerebral ischemia (TIA or infarct) (56%), and Horner syndrome (25%). Good outcome (defined as modified Rankin score of 0 to 2) was seen in 92% of patients. No recurrence of dissection was observed during a mean 7.8 years of follow-up. Conclusions: Internal carotid artery dissection was detected approximately twice as frequently as vertebral artery dissection in the overall study, but in the latter half of the study period, vertebral artery and internal carotid artery dissection incidence rates were equivalent. The majority of cervical artery dissection patients in the community have excellent outcome, and contrary to many tertiary referral series, re-dissection is rare.

Recurrent spontaneous cervical-artery dissection.

Abstract: Background Spontaneous dissection of the internal carotid and vertebral arteries is increasingly recognized as a cause of ischemic stroke in young people. An underlying arteriopathy is often suspected in the pathogenesis of such dissection, but the frequency of recurrent dissection is unknown. Methods We describe the long-term follow-up of 200 consecutive patients (104 women and 96 men) with spontaneous cervical-artery dissections evaluated at the Mayo Clinic between 1970 and 1990. All diagnoses were confirmed by angiography. Results The mean age of the patients was 44.9 years (range, 16 to 76). Internal carotid arteries were affected in 150 patients, vertebral arteries in 37, and both in 13. Multivessel dissections were present in 28 percent of the patients. The mean follow-up was 7.4 years. Recurrent dissection occurred only in arteries not previously involved by dissection. A recurrent arterial dissection developed in 16 patients (8 percent) -- within a month after the initial dissection in 4 patients ...