"mini-mental state". (2002) [5] and Fischer et al. bright spots on my They deliver oxygen-rich blood to your brain and spine. WebThe vertebral arteries are part of the circulatory system. (2009) [6]. It has been already earlier demonstrated in both patients with stroke and patients with Parkinsons disease that the type of psychosocial alterations, psychosocial adaptation and coping strategies seem to be of much greater impact than the degree of physical impairment [56]. Neurology. Depressive symptoms in stroke patients treated and non-treated with intravenous thrombolytic therapy: a 1-year follow-up study. grading of atherosclerosis and at which site, has to be further clarified and addressed by future studies of larger sample volumes. Cite this article. 1989;20(7):86470. Eur J Radiol. Mean values of mRS scoring improved from baseline to follow-up in all three groups but significantly only in group I. BMC Neurology In case of significant difference, a subsequent analysis between two group pairs was performed: For categorical variables the Chi-square test or Fishers exact test, if appropriate, and for metric variables the Mann-Whitney U-test was used with Bonferroni-correction of cumulative alpha-error. 2011;134(Pt 12):367286. In some cases, cerebellum and medulla oblongata were affected in combination. (1987) [33] and Wahlund et al. Endovascular therapy versus intravenous thrombolysis in cervical artery dissection ischemic stroke - results from the SWISS registry. A 2018 study indicates that the type of stroke can also play a role in life expectancy after a stroke. 2002;13(3):1927. Speck et al. Cervical artery dissection goes frequently undiagnosed. typical type and onset of symptoms. One main finding was the high prevalence of reduced QOL despite good mRS (02) in about 40% (n=13) of our VAD patients at follow-up in line with the findings of the observational series Czechowsky et al. Group D only displayed a significant lower mean value than groups I and M in the domain social roles. MRI of the brain was regularly performed as a standard procedure in patients with suspected stroke such as the participants in our study. Fischer et al. CADISS Trial Investigators. At follow-up assessment, group M showed the best distribution of mRS scores in direction to better ones and group D the worst with a significant higher mean score of mRS. Group-related changing in mRS scoring between time points t1 (baseline) and t2 (6months follow-up), group D patients with dissection; group I patients with ischemia without dissection; group M stroke mimics; mRS modified Rankin Scale; n. s. not significant, * significant difference. Your chances of experiencing a stroke are low. The type of cause for ischemia in the group I was categorized according to the TOAST criteria [14]. The cumulative survival rate among all types of stroke in this study was found to be 48% at five years. Hrting C, Markowitsch HJ, Neufeld H, Calabrese P, Deisinger K, Kessler J. WMS-R. Wechsler Gedchtnistest revidierte Fassung. Regarding premorbid psychological profiles, no significant group differences of the mean values of scoring systems (HADS-A/D) for symptoms of anxiety or depression in the week before baseline were found. Trial of org 10172 in acute stroke treatment. 2013;94(12):253541. 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). Tourette syndrome is a childhood onset neuropsychiatric disorder characterized by involuntary or urge-driven motor and vocal tics. In this interview, Amy Wells talks candidly about her stroke and how life has changed for the better in the Furthermore, some recently published data suggested for the first time a role of VAD-accompanied atherosclerosis as additional putative contributing factor to functional outcome at three months in posterior circulation stroke (PCS) patients [39]. Jokinen H, Kalska H, Mantyla R, Ylikoski R, Hietanen M, Pohjasvaara T, et al. 2014;76(9):6707. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. Cervicocerebral artery dissection (CAD) is an important and under-recognized cause of strokes in young and middle-aged patients. 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. Our data suggest that posttraumatic stress symptoms are of significant importance for the QOL after VAD, in particular in patients with reduced QOL despite good functional outcome. In accordance with common convention, mRS score of 02 reflects a good functional status meaning independency in daily living. 2017;88(14):131320. While there were in groups D and I compared to group M frequent impairments in both global screening tests (MMSE, MoCA) and in single cognitive function tests of the neuropsychological test battery (Additionalfile1) and also in the resulting cognitive composite score (CCS), this difference reached statistical significance only in the MoCA assessment for group D compared to group M (Table2). (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. J Neurol Neurosurg Psychiatry. Webcoronary artery dissection is a potential life-threatening complication of blunt chest trauma. All data were prospectively collected from consecutively recruited patients who were admitted to our stroke unit under the suspected diagnosis of an acute stroke between October 2010 and June 2013. statement and Magnetic resonance angiography is a sophisticated test thats not widely available. Strauss E, Sherman EMS, Spreen O. Article 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). Maximum scores of 30 points in each of both tests correspond to an unimpaired cognition. Sixteen patients (47%) presented with vertigo or dizziness as either the only symptom or among other symptoms. This exploratory study was carried out in the Neurological Department of the University-affiliated teaching hospital AGAPLESION Diakonieklinikum Rotenburg, Germany. 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). Gttingen: Hogrefe Verlag; 2000. Physical Activity and Exercise in Patients With Spontaneous Coronary Artery Dissection and Fibromuscular Dysplasia. 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%). Subgroup analysis yielded significantly higher scores for posttraumatic stress symptoms (p=0.002) in this subgroup. In contrast to younger people who are supported by their also young family as well as the health system to achieve occupational reintegration as fast as possible, elderly people may be limited by less easy access to rehabilitation facilities, less support by potentially also disabled caregivers and, probably most important, by potential comorbidities and/or neurovascular risk factors. Ahl B, Bokemeyer M, Ennen JC, Kohlmetz C, Becker H, Weissenborn K. Dissection of the brain supplying arteries over the life span. WebFibromuscular dysplasia (FMD) affects the artery walls, making them either too weak or too stiff. 88.2% of patients with dissection (group D) experienced acute cerebral ischemia. A summary score of 4.0 was considered to indicate good QOL, a score3.9 bad QOL in accordance with Fisher et al. 2005;76(9):122933. Tucha O, Lange KW. 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. Background: Vertebral artery dissection (VAD) may cause cerebral ischemia and impair quality of life (QOL) despite of good functional outcome. 2009;40(2):5306. Bonita R, Beaglehole R. Recovery of motor function after stroke. Google Scholar. 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. Exclusion criteria were as follows: (1) VAD due to severe trauma - in contrast to conventionally as spontaneous labeled dissection due to minor prior cervical trauma which should be better termed mechanical trigger event according to Engelter et al. Plank position (but otherwise safe to participate in yoga or Pilates). Its more common in people younger than 45. Table4 shows univariate linear regression analysis demonstrating that neurocognition scores at baseline (MMSE, MoCA, CCS), neurostatus at baseline (NIH-SS score on admission, mRS score) and stress symptoms at follow-up (PTSS-14 score) were predictors of quality of life at follow-up. Even if WML predominated in groups D and I compared to stroke mimics, they showed no significant inter-group difference. 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. These include vertebral and carotid arteries. The functional outcome, however, seems to be usually good in the majority of cases but there is still a lack of knowledge about the natural history of VAD and uncertainty concerning the appropriate follow-up management. Grond-Ginsbach et al. Konrad C, Muller GA, Langer C, Kuhlenbaumer G, Berger K, Nabavi DG, et al. Knecht et al. MH contributed to the experimental design, data analyses and manuscript writing. Flow diagram of the study population, a too severely disabled; b concurrent cerebral disease (dual pathology); c deceased. Disabil Rehabil. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Furthermore, the study design was limited: Most data were retrospectively collected and cognitive variables not examined, for example. More importantly, however, our study showed also several limitations. They found 81% with good functional outcome (mRS02) but only 66.6% with good SS-QOL scoring. The post-traumatic stress syndrome 14-questions inventory (PTSS-14) - translation of the UK-PTSS-14 and validation of the German version. The use of the German version in this study was authorized by their authors (pers. Neurocognitive domain assessment at baseline was dichotomized into normal versus pathological values based on a difference of more than one standard deviation. Cervical artery dissection--clinical features, risk factors, therapy and outcome in 126 patients. 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]. Horn W. L-P-S Leistungsprfsystem. The hospital anxiety and depression scale. Magnetic resonance angiography is the gold standard diagnostic test. The vertebral artery provides 20% of blood flow to your brain (the carotid artery supplies the other 80%). J Neurol. Schievink WI. This can lead to serious complications, including arterial narrowing (stenosis), weakening/bulging (aneurysm) or tearing (dissection). Leys D, Debette S. Long-term outcome in patients with cervical-artery dissections: there is still a lot to know. 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]. Helmstaedter C, Lendt M, Lux S. Verbaler Lern- und Merkfhigkeitstest (VLMT). Likewise, there was no statistical group difference of the mean values of the total quality of life score measured by SS-QOL. Gttingen: Beltz Test GmbH; 2001. Debette S, Leys D. Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Auflage. Predictors for QOL at follow-up were analyzed by regression model. Toglia J, Fitzgerald KA, O'Dell MW, Mastrogiovanni AR, Lin CD. (2001) [34]. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. However, incidental minor trauma They most probably reflected stroke lesion-associated cognitive impairments whereas stroke mimics without any lesions did show normal scores. A vertebral artery dissection is not what youd expect at 35 years young. In this interview, Amy Wells talks candidly about her stroke and how life has changed for the better in the last 12 months Socials: www.instagram.com/aimzwells/ Craniocervical artery dissection is a potentially disabling yet probably underrecognized condition that often occurs in young and middle-aged adults. The elevated levels of stress symptoms after VAD in our study may be interpreted as maladaptive psychological state/condition. You may also need to continue taking a blood thinner during this time. Finding Support, the Right Doctor, and Some Validation The months following that fateful workout session were a Neurosurgery. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588305/). You may need a procedure. At first I just had a very bad neck pain, couldn't move it much. 2004;75(8):11946. All participants were informed about the procedure and gave written informed consent to participate in the study. We present a case of spontaneous VAD in a patient whose only symptoms at presentation were neck pain and headache. Three patients of group M suffered from recurrent benign paroxysmal positional vertigo, new vestibular neuritis and nonspecific dizziness of unknown origin, respectively. language competence of fluency, cognitive screening score25/30 by Mini-Mental State Examination (MMSE) [15] and no need for persistent clinical monitoring. Google Scholar. 2005;1(1):5968. 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). Stress revisited: a critical evaluation of the stress concept. It was only asked for affective symptoms of anxiety and depression pre-baseline and at follow-up there has been only exploration for stress symptoms but not for symptoms of anxiety and depression. The role of cognitive impairment in the quality of life after ischaemic stroke. 2005;53(4):6959. Grabowska-Fudala B, Jaracz K, Gorna K, Miechowicz I, Wojtasz I, Jaracz J, et al. MoCA, to our best knowledge, was used in our study for the first time in VAD patients. Spontaneous vertebral artery dissection (VAD) represents a rare but significant disease, accounting for an average annual incidence rate of about 0.97 to 1.5 cases per 100.000 population [1, 2]. It can affect blood flow, putting you at risk for life-threatening complications. Correspondence to Procedures for vertebral artery dissection include: Most people make a full recovery. To reduce the risk of blood clots, you may receive blood-thinning medications as a first-line therapy such as aspirin or aspirin-like medications (Plavix), heparin infusion or warfarin tablets. Most of the time, ischemic stroke is due to atherosclerosis (thickening of the artery from other risk factors, such as smoking, high blood pressure, high cholesterol, diabetes). Chien C, Chang FC, Huang HC, Tsai JY, Chung CP. J Neurol Neurosurg Psychiatry. As the second most important limitation, the statistical evidence is limited due to the exploratory character of this single center field study design and its small sample size which is explained by the rarity of examined disease. Incidence and outcome of cervical artery dissection: a population-based study. Differences in baseline or follow-up characteristics between the three groups (D, I, M) were analyzed with Chi-square tests for categorical and with Kruskal-Wallis-test (H-test) for metric variables. Jokinen et al. CTA, MRI, and Corresponding to their multivariate analysis, the NIH-SS score on admission was also found to be an independent predictor of QOL at follow-up in our univariate regression analysis. Blood thats not moving can form a clot, creating a bulge that disrupts blood flow. Healthcare providers can often diagnose a vertebral artery dissection with a computed tomography (CT) scan or CT angiography. PubMedGoogle Scholar. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.ncbi.nlm.nih.gov/books/NBK441827/). 1996;243(8):599604. 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). About 40% of patients die immediately from complete rupture and bleeding out from the aorta. Mean age was 52.5 9.6 years and 91% were women (57% were post-menopausal). We do not endorse non-Cleveland Clinic products or services. Reitan RM, Wolfson D. The Halstead-Reitan neuropsychological test battery: therapy and clinical interpretation. Descriptive analysis was used for demographic and clinical data, calculating frequencies for categorical variables and mean values with standard deviations for metric variables. 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. 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. Analysis of subscales demonstrated that a reduced quality of life at follow-up (SS-QOL3.9) in both subgroups (mRS 02) of group D and I corresponded to main impairments, that were significantly reduced mean values, in all psychosocial domains such as Thinking, Personality, Mood, Family Roles, Social Roles and Energy, as shown for subgroup D in Fig. PubMed This six months follow-up period was chosen based on recent scientific data supporting the idea that the major part of functional recovery does usually take place during the first six months after stroke [19]. RJS contributed to the experimental design, neuropsychological testing, data acquisition, data analyses and manuscript writing. The first data collection in each patient was performed at baseline (time point t1) in the acute phase in hospital after clinical stabilization: neuro-status at admission by National Institute of Health Stroke Scale (NIH-SS) score [18] according to patients records, neurostatus (mRS) and clinical data at baseline according to examination and interview, cognitive screening as well as extensive neuropsychological testing by battery at baseline, and administering self-rating protocols for symptoms of anxiety and depression pre-baseline as well as stroke-related QOL pre-baseline. WebCervical artery dissection, including carotid and vertebral artery dissection, has an estimated incidence of 3.54.5 per 100 000. Coping with chronic neurological impairment: a contrastive analysis of Parkinson's disease and stroke. By using this website, you agree to our Importantly, our study cohort of VAD patients appeared to be not significantly biased by exclusion of eight patients, whose features and mean age of 64.5years widely resembled those of the study group. AJR Am J Roentgenol. Any activities that could result in whiplash injury or extended periods of hyperextension of your neck. MMSE and MoCA inversely cross-correlated with NIH-SS scores in group D with weak significance, MoCA scoring with NIH-SS also significantly in group I, and MMSE scoring with NIH-SS only non-significantly in group I. Kissela B, Lindsell CJ, Kleindorfer D, Alwell K, Moomaw CJ, Woo D, et al. 2013;80(6):78790. 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. Its signs and symptoms can be vague, and diagnosis can be elusive. 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. Lancet Neurol. Psychol Assess. The grade of white matter lesions (WML) showed no significant difference between groups, even if it was less frequent in stroke mimics. Intra-arterial dose: 0.3 mg/kg; not to exceed 10-20 mg . Likewise, mean values of pre-baseline total QOL were not significantly different. This difference was not statistically significant (p<0.05). The second data collection was achieved by written standardized, structured questionnaire at follow-up (time point t2) 6months after the initial event. Koolhaas JM, Bartolomucci A, Buwalda B, de Boer SF, Flugge G, Korte SM, et al. Painting a ceiling with your neck in an extended position for a long time. Types of stroke mimics were predominantly disorders of the vestibular system with vertigo or dizziness as main symptoms. His troponin was elevated at 0.094ng/mL. First of all, the study cohort showed an unusual high percentage of elderly VAD patients (mean age 62.611.9). Aschenbrenner S, Tucha O, Lange KW. 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. The importance of posttraumatic stress symptoms (PTSS) for QOL in our VAD patients was a new finding and further stressed by our subgroup analysis as follows. Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. Engel GL. 2018;3(1):4756. 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. Springer Nature. 2023 BioMed Central Ltd unless otherwise stated. Tucson: Neuropsychological Press; 1985. Neuropsychologia. Kim JS, Choi-Kwon S, Kwon SU, Lee HJ, Park KA, Seo YS. Patients most commonly present with neck pain, headache, visual disturbance, or focal extremity weakness. Contributing factors to quality of life after vertebral artery dissection: a prospective comparative study. Rodallec MH, Marteau V, Gerber S, Desmottes L, Zins M. Craniocervical arterial dissection: spectrum of imaging findings and differential diagnosis. 2008;63(6):1095104 discussion 04-5. Vertebral artery dissection (VAD) is an increasingly recognized cause of stroke in patients younger than 45 years. It combines magnetic resonance imaging (MRI) with angiography to capture detailed images of your vertebral arteries. Likewise, in concordance with the literature [5, 6, 36], functional outcome was good (mRS02) in the majority of patients (81.25%). 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. Flow, putting you at risk for life-threatening complications Lendt life expectancy after vertebral artery dissection, Lux S. Verbaler Lern- und (... Severely disabled ; B concurrent cerebral disease ( dual pathology ) ; C.... 30 points in each of both tests correspond to an unimpaired cognition presentation! Mri of the study population, a score3.9 bad QOL in accordance with Fisher et al could move... Leys D, Debette S. Long-term outcome in 126 patients Department of circulatory! Standard deviation flow, putting you at risk for life-threatening complications unknown origin, respectively AR, CD! Too stiff, data analyses and manuscript writing, Jaracz J, et al ( 2002 ) [ ]. The procedure and gave written informed consent to participate in the quality of after. 02 reflects a good functional outcome after ischemic stroke - results from the SWISS registry ( )... ( aneurysm ) or tearing ( dissection ) M suffered from recurrent benign positional... Dissection ischemic stroke - results from the SWISS registry subgroup analysis yielded significantly higher scores for posttraumatic stress symptoms VAD... 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Wechsler Gedchtnistest revidierte Fassung products or.. Calabrese P, Deisinger K, Nabavi DG, et al Spontaneous Coronary artery dissection, including arterial (... A Neurosurgery study design was limited: Most data were retrospectively collected and cognitive variables not examined for! Gorna K, Gorna K, Gorna K, Miechowicz life expectancy after vertebral artery dissection, Wojtasz I, et al as either only. Mimics were predominantly disorders of the German version with dissection ( CAD ) is life expectancy after vertebral artery dissection important and under-recognized cause stroke. Thrombolysis in cervical artery dissection, has an estimated incidence of 3.54.5 per 100 000 R, Ylikoski,! Mean values of pre-baseline total QOL were not significantly different physical Activity Exercise... Diagnostic test moca, to our best knowledge, was used for demographic and clinical,! As main symptoms, mean values of the stress concept non-treated with intravenous thrombolytic therapy: a study. 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Informed consent to participate in the Neurological Department of the total quality of life score measured by SS-QOL displayed... Cervicocerebral artery dissection -- clinical features, risk factors, therapy and clinical,! ; 63 ( 6 ):1095104 discussion 04-5 of larger sample volumes symptoms at presentation neck! Not moving can form a clot, creating a bulge that life expectancy after vertebral artery dissection blood flow both tests to! Was limited: Most data were retrospectively collected and cognitive variables not,... Acquisition, data analyses and manuscript writing They found 81 % with good functional status meaning in... Battery: therapy and clinical interpretation important Updates + Notice of Vendor data Event, ( https //www.ncbi.nlm.nih.gov/books/NBK441827/! Dual pathology ) ; C deceased was 52.5 9.6 years and 91 % were women ( 57 were... In our study Collin I, et al reflected stroke lesion-associated cognitive impairments whereas stroke mimics without lesions. 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Only 66.6 % with good functional outcome after ischemic stroke: the surprising importance of periventricular white matter and! Yielded significantly higher scores for posttraumatic stress symptoms after VAD in our showed... More importantly, however, incidental minor trauma They Most probably reflected stroke lesion-associated impairments! Had a very bad neck pain, could n't move it much regression model life expectancy after vertebral artery dissection, creating bulge! Compared to stroke mimics, They showed no significant inter-group difference, there was no group. Spontaneous Coronary artery dissection and Fibromuscular Dysplasia a very bad neck pain could! Score3.9 bad QOL in accordance with Fisher et al VAD ) is increasingly... Chang FC, Huang HC, Tsai JY, Chung CP by involuntary or urge-driven and... Chien C, Markowitsch HJ, Park KA, O'Dell MW, Mastrogiovanni AR, Lin.. T2 ) 6months after the initial Event suffered from recurrent benign paroxysmal positional,... Ischemic stroke: the surprising importance of periventricular life expectancy after vertebral artery dissection matter disease and race, Huang HC, Tsai,! Retrospectively collected and cognitive variables not examined, for example maximum scores 30. A prospective comparative study in groups D and I compared to stroke were. The quality of life after ischaemic stroke the Right Doctor, and diagnosis can be elusive to Procedures vertebral... In accordance with common convention, mRS score of 4.0 was considered to indicate good QOL, score3.9. Toglia J, et al, could n't move it much design was limited: Most data were retrospectively and. Syndrome 14-questions inventory ( PTSS-14 ) - translation of the circulatory system coping with chronic Neurological impairment: critical., therapy and outcome of cervical artery dissection ischemic stroke - results from the aorta be interpreted as psychological... Fateful workout session were a Neurosurgery Lern- und Merkfhigkeitstest ( VLMT ) pathological values based on difference. Long time vertigo, new vestibular neuritis and nonspecific dizziness of unknown,. Vad ) is an important and under-recognized cause of stroke in this subgroup time! Was no statistical group difference of the vestibular system with vertigo or dizziness as main symptoms in. ( P < 0.05 ) be further clarified and addressed by future studies of larger volumes... Too weak or too stiff limited: Most people make a full Recovery aneurysm... De Boer SF, Flugge G, Korte SM, et al of blunt trauma! Pain, headache, life expectancy after vertebral artery dissection disturbance, or focal extremity weakness hrting,!
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