2012;13:164. The PTSS-14 was developed by Twigg et al. PubMed Up to 25% of stroke cases in this age group are due to vertebral artery dissection. 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. SS-QOL scores at follow-up varied among subgroups as demonstrated in a subgroup analysis stratified for good functional outcome (mRS 02) plus good quality of life (SS-QOL4.0) versus good functional outcome (mRS 02) plus bad quality of life (SS-QOL3.9). Maximum scores of 30 points in each of both tests correspond to an unimpaired cognition. (2004) [45]. Blood in the separated layers of the vessel wall can lead to blood clot formation. With a dissection, blood gets trapped between the intima and media. In this interview, Amy Wells talks candidly about her stroke and how life has changed for the better in the All authors read and approved the final manuscript. Patient-specific recovery patterns over time measured by dependence in activities of daily living after stroke and post-stroke care: the South London Stroke Register (SLSR). Zigmond AS, Snaith RP. There was a high responder rate in follow-up assessments: follow-up data were obtained in 97% of patients in group D, 100% in group I, and 96% in group M. Secondary ischemia prevention by medication until follow-up was provided by platelet aggregation inhibitors in 76.5% patients of group D and 81.6% of group I and oral anticoagulants in 23.5% patients of group D and 18.4% of group I. Vascular events of importance occurred until follow-up time point as follows: In group D one recurrent stroke, one suspected stroke, one new stroke due to dissection of the internal carotid artery, and one transient ischemic attack. 2009;40(2):5306. Article According to modern stress concepts, situations that in particular include unpredictability and uncontrollability can trigger stress [54]. Gttingen: Beltz Test GmbH; 2001. 2003;250(10):117984. Not applicable. Risk factors and clinical presentation of craniocervical arterial dissection: a prospective study. 1980;137(5):53544. Subgroup-analyses were calculated for patients with mRS 02 and SS-QOL4.0 versus those with mRS 02 and SS-QOL3.9. Administration, norms, and commentary. Furthermore, there was no physical follow-up examination conducted, only a follow-up assessment by questionnaire. They included benign paroxysmal positional vertigo in 40%, vestibular neuritis in 24%, vestibulocochlear irritation in 4%, Schwannoma in 4%, suspected somatoform dizziness in 8% and nonspecific dizziness of unknown origin in 16%. At first I just had a very bad neck pain, couldn't move it much. 2016;87(5):52630. Physical Activity and Exercise in Patients With Spontaneous Coronary Artery Dissection and Fibromuscular Dysplasia. Neurology. Rainer J. Strege. The finding of more neurocognitive impairments in form of lower mean values in cognitive measures in patients with ischemic lesions of both group D and group I patients did not reach significance. Otherwise, antithrombotic therapy was (2009) [40] reported that severe periventricular white matter disease was significantly associated with poor functional outcome at 3months after ischemic stroke, independently of other factors. Any activities that could result in whiplash injury or extended periods of hyperextension of your neck. 2008;63(6):1095104 discussion 04-5. Zubin J, Spring B. In contrast to the primary application of the English version to intensive care unit patients, the German version was recently validated for its use on a broader spectrum of patients [21]. (2015) [61] reported that older stroke patients in general have worse prestroke status, greater impairment on hospital admission, more comorbidities and poorer poststroke functional status than the younger patients but can benefit as much as the young from high-intensity neurorehabilitation. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. 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. Psychol Assess. Debette S, Grond-Ginsbach C, Bodenant M, Kloss M, Engelter S, Metso T, et al. 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. Chien C, Chang FC, Huang HC, Tsai JY, Chung CP. This method enables healthcare providers to quickly pinpoint the dissection and determine its severity and acuity. Mean age was 52.5 9.6 years and 91% were women (57% were post-menopausal). Apart from severity of neurological disorders, as scored by mRS, and impaired neuropsychological performance at baseline, as measured by global cognitive screening in form of MMSE, elevated posttraumatic stress symptoms levels, as assessed by Post-Traumatic Stress Syndrome 14-Questions Inventory (PTSS-14), proved to be an independent predictor for reduced QOL at follow-up in group D patients after VAD according to multivariate regression analysis. PubMed J Neurol Neurosurg Psychiatry. 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. PubMed Central [43] who preoperatively examined patients with cerebellar hematomas or brain tumors by the same neuropsychological tests apart from not using LPS as we did. 1983;67(6):36170. J Neurol. Psychological self assessment for symptoms of depression (HADS-D/D), symptoms of anxiety (HADS-D/A), and posttraumatic stress symptoms (PTSS-14) showed significantly positive correlations in all groups. Clinical monitoring should address this topic to make timely treatment possible. Study participants were asked at follow-up to answer 14 items of the PTSS-14 inventory regarding stress symptoms in the previous week. BMC Neurol 19, 312 (2019). We do not endorse non-Cleveland Clinic products or services. 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. The study protocol was approved by the Local Ethics Committee of the University of Bremen. Trends towards worse cognitive function without statistical significance were found in group D and I compared to group M for the following cognitive domains: divided and selective attention (TAP), combined attention and executive function (TMT A and B), mental rotation (LPS-7), and spatial cognitive function (FPT). 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). Other activities with rapid acceleration/deceleration changes. The statistical data analyses were conducted using SPSS Statistics Version 22 and WinStat, Bad Krozingen. The type of cause for ischemia in the group I was categorized according to the TOAST criteria [14]. Neurology. WebMethods: Clinical and radiological data of 114 patients with sCAD were collected prospectively. All groups (D, I, and M) displayed a significant correlation between age and white matter lesions (WML). Hemorrhagic stroke was found to result in a lower survival rate or lower level of functionality than ischemic stroke. 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. Cerebrovasc Dis Extra. Symptomatic intracranial vertebral artery atherosclerotic stenosis (>/=70%) with concurrent contralateral vertebral atherosclerotic diseases in 88 patients treated with the intracranial stenting. Vertebral artery hemodynamics can be evaluated by assessing: (1) the presence or absence of flow, (2) blood flow direction and alteration of the waveform shape, (3) vertebral artery size, and (4) the peak systolic and end-diastolic velocities. 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%. 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. The vertebral arteries have many small branches. CADISS Trial Investigators. Complete data analysis of paired mRS and SS-QOL scores at follow-up was possible in all 33 surviving patients of group D but one who provided only incomplete SS-QOL data. Flow diagram of the study population, a too severely disabled; b concurrent cerebral disease (dual pathology); c deceased. Neurology. That is in particular striking regarding VAD. Czechowsky et al. Types of stroke mimics were predominantly disorders of the vestibular system with vertigo or dizziness as main symptoms. Noble et al. 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. Among physical domains only the domain work showed also deterioration in groups D and I. 1989;20(7):86470. 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. Last reviewed by a Cleveland Clinic medical professional on 08/07/2022. Helmstaedter C, Lendt M, Lux S. Verbaler Lern- und Merkfhigkeitstest (VLMT). (2008) [47] in the United Kingdom (UK) as a new, more practical screening tool for post-traumatic stress disorder (PTSD). Your healthcare provider may recommend alternative treatments. Patients most commonly present with neck pain, headache, visual disturbance, or focal extremity weakness. Previous studies described poststroke cognitive decline by global cognitive screening such as MMSE and more recently and more sensitively by MoCA [42]. Med Hypotheses. Achievable are 14 to 98 points from 14 items. However, you may be at risk for future dissections. Neuropsychologia. This difference was not statistically significant (p<0.05). Jokinen H, Kalska H, Mantyla R, Ylikoski R, Hietanen M, Pohjasvaara T, et al. Living With Whats it like living Google Scholar. Five-point test. 1988;19(12):1497500. Other published data remained inconsistent. We present a case of spontaneous VAD in a patient whose only symptoms at presentation were neck pain and headache. This process usually occurs within the first three to six months. Fischer et al. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588305/). 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]. 2006;37(10):2499503. These include vertebral and carotid arteries. Acta Psychiatr Scand. 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. Exner C, Weniger G, Irle E. Cerebellar lesions in the PICA but not SCA territory impair cognition. Strege, R.J., Kiefer, R. & Herrmann, M. Contributing factors to quality of life after vertebral artery dissection: a prospective comparative study. J Neurol Neurosurg Psychiatry. Cerebrovasc Dis. Current recommendations for patients with FMD are to avoid resistance training during the first 8-12 weeks after acute carotid or vertebral artery dissections. Grond-Ginsbach C, Metso TM, Metso AJ, Pezzini A, Tatlisumak T, Hakimi M, et al. Folstein MF, Folstein SE, McHugh PR. J Neurol. WebVertebral artery dissection occurs when a tear forms in one of the blood vessels running up the back of your neck. Three patients of group M suffered from recurrent benign paroxysmal positional vertigo, new vestibular neuritis and nonspecific dizziness of unknown origin, respectively. WebThe vertebral arteries are part of the circulatory system. Horn W. L-P-S Leistungsprfsystem. In an exploratory study, 34 consecutive patients with first-ever spontaneous VAD were prospectively examined in comparison to 38 patients with cerebral ischemia without dissection and 25 stroke mimics as control groups. Regensburger Wortflssigkeitstest. VAD leads to impaired QOL at 6months follow-up due to multiple factors. Third, apart from elevated scores of stress symptoms significantly lower scores of the SS-QOL item self-confidence within the domain mood were found at follow-up. Their high PTSD prevalence might be overestimated because physically less affected people voluntarily participating in their study might have tended to mention more mental problems when asked by self-rating PDS. Plank position (but otherwise safe to participate in yoga or Pilates). 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. ( D, I, and M ) displayed a significant correlation between age white..., Metso T, Hakimi M, et al tests correspond to life expectancy after vertebral artery dissection... 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Vad life expectancy after vertebral artery dissection a lower survival rate or lower level of functionality than ischemic stroke and clinical presentation craniocervical! The separated layers of the University of Bremen concepts, situations that in particular include unpredictability and uncontrollability trigger... In Alzheimer 's dementia and normal aging a lower survival rate or level... Survival rate or lower level of functionality than ischemic stroke assessment by questionnaire providers to quickly pinpoint dissection!
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life expectancy after vertebral artery dissection