1/38. Cranial arteritis: a medical emergency with orofacial manifestations.BACKGROUND: Cranial arteritis, or CA, a vascular disease affecting primarily elderly people, may result in permanent blindness if untreated. Since it frequently mimics temporomandibular joint, myofascial or odontogenic pain, dentists must be familiar with this condition. CASE DESCRIPTION: The authors present reports of two patients who had signs and symptoms of CA, some of which were suggestive of other head and neck pain disorders. In both cases, the diagnosis of CA was confirmed by temporal artery biopsy, and treatment with systemic steroids resulted in rapid resolution of symptoms. CLINICAL IMPLICATIONS: Prompt diagnosis and treatment of CA not only results in resolution of symptoms, but also may prevent blindness, the most serious sequela of the condition.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/38. Bilateral vertebral artery dissection causing a cerebrovascular accident in pregnancy. A case report.BACKGROUND: vertebral artery dissection, occurring spontaneously or following a traumatic event, is a cause of posterior circulation stroke in young individuals, including pregnant women. CASE: A 20-year-old, primagravid woman acutely developed headache, right-sided hemiparesis and parasthesias, and blurred vision. Within days she complained of cervical neck pain. magnetic resonance imaging findings were consistent with a posterior circulation cerebrovascular accident (CVA). An arteriogram, performed to exclude vasculitis, revealed bilateral vertebral artery dissection. No inciting event could be recalled. CONCLUSION: Vascular dissections occur rarely during pregnancy. Spontaneous extracranial vertebral artery dissection itself is very rare in general. Cerebral ischemia can follow vertebral artery dissection. In young patients with CVA, consideration of the diagnosis of vertebral artery dissection followed-by angiography and anticoagulation is an important component of the workup and care.- - - - - - - - - - ranking = 9keywords = artery (Clic here for more details about this article) |
3/38. Central retinal artery occlusion associated with head or neck pain revealing spontaneous internal carotid artery dissection.PURPOSE: To report two cases of head or neck pain and central retinal artery occlusion associated with spontaneous dissection of the ipsilateral internal carotid artery. methods: case reports. RESULTS: We describe two cases of sudden visual loss caused by central retinal artery occlusion. Both cases were preceded by ipsilateral headaches or neck pain and tinnitus. The patient had no other neurological signs or history of trauma. In both cases, cerebral angiography revealed ipsilateral internal carotid artery dissection. CONCLUSION: Ipsilateral headache or neck pain with tinnitus preceding central retinal artery occlusion is highly suggestive of internal carotid artery dissection. early diagnosis and treatment may reduce the risk of hemispheric stroke.- - - - - - - - - - ranking = 179.67886659222keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
4/38. Extracranial vertebral artery dissection causing cervical root lesion.The authors report an unusual manifestation of extracranial vertebral artery dissection (VAD), presenting with a predominantly motor radicular manifestation. Cervical magnetic resonance imaging (MRI) revealed the intramural hematoma in the dissected vessel wall, compressing mainly the segmental motor root and, to a lesser degree, the sensory ganglion. In the digital subtraction angiography (DSA), a circumscribed narrowing of the incriminated vessel was demonstrated. color-coded Duplex imaging (CDDI) revealed complete recanalization after a few days of anticoagulation treatment. Complete neurologic recovery was seen after 3 months. Considering the MRI data, the likely pathogenetic mechanism was compression of the nerve root by the intramural hematoma. The synopsis with similar cases in the literature points to the characteristic features, i.e., the association of neck pain with radicular motor deficit and the absence of degenerative disk disease. The respective syndrome should raise the suspicion of vertebral artery dissection, especially in young individuals.- - - - - - - - - - ranking = 6keywords = artery (Clic here for more details about this article) |
5/38. neck pain after minor neck trauma--is it always neck sprain?We report a patient who had headache and neck pain after whiplash injury and subsequently developed cerebellar infarction due to vertebral artery dissection. This patient's pain was out of proportion to his apparent injury and it was a clue to the final diagnosis. Gross motor examination for cord injury may not be adequate for patients with minor neck trauma. Detailed cranial nerve and cerebellar examination should be performed for detection of circulatory insufficiency. Discharge advice for patients should also include that of stroke or transient ischaemic attack.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
6/38. A cervical anterior spinal artery syndrome after diagnostic blockade of the right C6-nerve root.A 48-year-old man suffered from intractable neck pain irradiating to his right arm. magnetic resonance imaging (MRI) of the cervical spine was unremarkable. A right-sided diagnostic C6-nerve root blockade was performed. Immediately following this seemingly uneventful procedure he developed a MRI-proven fatal cervical spinal cord infarction. We describe the blood supply of the cervical spinal cord and suggest that this infarction resulted from an impaired perfusion of the major feeding anterior radicular artery of the spinal cord, after local injection of iotrolan, bupivacaine, and triamcinolon-hexacetonide around the C6-nerve root on the right side.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
7/38. Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck.PURPOSE: To report a case of Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck. methods: Case report. A 44-year-old woman with no prior ocular or vascular history presented with severe right-sided head and neck pain, ptosis, and miosis following chiropractic treatment for a strained right shoulder muscle. RESULTS: magnetic resonance angiography of the neck and brain revealed a dissection of the right internal carotid artery as well as a suggestion of subtle dissection in the right vertebral artery. No significant brain abnormalities were noted on magnetic resonance imaging. Pharmacological testing was consistent with preganglionic oculosympathetic damage. CONCLUSION: Acute, painful Horner's syndrome as a manifestation of vascular dissection may be associated with chiropractic manipulation of the neck.- - - - - - - - - - ranking = 149.01045707905keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
8/38. Anomalous vertebral artery-induced cervical cord compression causing severe nape pain. Case report.The authors describe a very rare case of cervical cord compression caused by anomalous bilateral vertebral arteries (VAs). A 65-year-old woman had been suffering from intractable nape pain and torticollis. magnetic resonance imaging revealed a signal void region in which spinal cord compression was present. Angiography demonstrated anomalous bilateral VAs compressing the spinal cord. Microvascular decompressive surgery was successfully performed. Neuroradiological and intraoperative findings are presented.- - - - - - - - - - ranking = 4keywords = artery (Clic here for more details about this article) |
9/38. Cervical manipulation to a patient with a history of traumatically induced dissection of the internal carotid artery: a case report and review of the literature on recurrent dissections.OBJECTIVE: To describe the use of rotational cervical manipulation in treating a patient who had undergone a traumatically induced dissection of the internal carotid artery and to review the literature on recurrent cervical artery dissections. CLINICAL FEATURES: A 21-year-old woman with hemiparesis from an internal carotid artery dissection that occurred as the result of a motor vehicle accident had neck pain and headaches. Moderate range of motion restrictions in the neck were present along with articular restrictions to movement palpation. INTERVENTION AND OUTCOME: After a year of soft-tissue treatment, we obtained detailed, informed consent from the patient to attempt diversified manipulation to the neck. The patient described greater and more immediate relief and longer pain-free periods than could be achieved by soft-tissue treatment alone. CONCLUSION: patients with previous cervical artery dissections may present with unrelated neck pain and headaches and request treatment. In selected cases, with complete informed consent, manipulation of the neck may relieve these symptoms. A review of published case reports on recurrent dissections suggests that trauma is not a significant factor in the second dissection. Care must be taken in extrapolating the results from this case to any other patient with a history of cervical artery dissection.- - - - - - - - - - ranking = 151.01045707905keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
10/38. Carotid dissection: a common cause of Horner's syndrome.PURPOSE: To highlight that internal carotid artery dissection is a common cause of Horner's syndrome and that it is important to diagnose dissection as anticoagulation can prevent carotid thrombosis and embolism. methods: Five case reports are presented of patients with Horner's syndrome secondary to carotid dissection. One patient had carotid dissection secondary to trauma, two had spontaneous dissections and two had dissections in the settings of other illness. A literature search was performed on carotid dissection as a cause of Horner's syndrome and its diagnosis and management. RESULTS: The case reports and literature highlight that dissection is under-recognized as a cause of Horner's syndrome and can be missed. The investigation of choice is a magnetic resonance imaging and angiography scan of the head and neck. The treatment advocated is anticoagulation for 3-6 months. CONCLUSION: Carotid dissection should be suspected in patients with Horner's syndrome, particularly if head or neck pain is present.- - - - - - - - - - ranking = 71.407397522635keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
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