life expectancy after vertebral artery dissection

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). Secondary exclusion due to defined criteria decreased the number of baseline patients of group D to 34 and group M to 25. (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. 1). Another woman (47years old; locked in-syndrome due to pontine infarction by basilar artery occlusion due to vertebral artery dissection) and a man (77years old; dizziness, nausea, vomiting, headache, ataxia, facial weakness, dysarthria, dysphagia; combined medulla oblongata and cerebellar infarction) without a sufficient ability to speak for participating in neuropsychological testing. 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/. 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). 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). Over the last years, cervical artery dissection has been increasingly diagnosed due to improved neuroimaging methods [58]. Eur Stroke J. We do not endorse non-Cleveland Clinic products or services. Kissela B, Lindsell CJ, Kleindorfer D, Alwell K, Moomaw CJ, Woo D, et al. 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 mRS is considered to be the worldwide most established functional outcome measure after stroke. The risk of dying can be as high as 1% to 3% per hour until the patient gets treatment. Definitions for use in a multicenter clinical trial. J Neurol Neurosurg Psychiatry. However, vertebral artery dissection is a common cause of stroke in young and middle-aged adults. 2014;45(11):33606. Neurology. Vertebral artery dissection (VAD) may cause cerebral ischemia and impair quality of life (QOL) despite of good functional outcome. Coping with chronic neurological impairment: a contrastive analysis of Parkinson's disease and stroke. 2005;53(4):6959. CADISS Trial Investigators. It can be induced by a particular head or neck posture; its early signs often include headache and neck pain. 2017;88(14):131320. Tedesco AM, Chiricozzi FR, Clausi S, Lupo M, Molinari M, Leggio MG. In accordance with common convention, mRS score of 02 reflects a good functional status meaning independency in daily living. TOAST. Because data on the potential impact of infarct volume to outcome and QOL in VAD patients have been lacking so far, we used at least a very arbitrary method for semiquantitative evaluation of the extension of infarct lesions and were not able to ascertain any statistical association. (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. Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J, et al. grading of atherosclerosis and at which site, has to be further clarified and addressed by future studies of larger sample volumes. Participants were examined for psychological, cognitive and neurological variables with special reference for functional outcome as well as quality of life 6months after the index event. 2014;23(2):33542. PubMed Central In earlier stages, you might not notice symptoms. 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. Gttingen: Hogrefe Verlag; 1983. Cervicocerebral artery dissection (CAD) is an important and under-recognized cause of strokes in young and middle-aged patients. 2014;76(9):6707. Apart from (1) the computer-based test battery for alertness, divided and selective attention (TAP) [24], all other tests were paper and pencil tests: (2) Trail Making Test (TMT A and B) for combined attention and executive function [25], (3) the Tower of London (TL-D) for executive function [26], (4) mental rotation (LPS 7) for visual-spatial function [27], (5) the Five-Point Test (5PT) for spatial-cognitive function [28], (6) the Regensburger Wortflssigkeitstest (RWT) for verbal fluency [29], (7) Verbal Learning and Memory Test (VLMT) [30], (8) Block tapping (BT) for the visual digit span [31] and (9) the Finger Tapping Test (FTT) for the hand motor function [32]. In the SSQOL-subgroup analysis of patients with good functional outcome (mRS score2) and good SS-QOL score (4.0) at follow-up were eight patients with arterial occlusion or subtotal occlusion versus five with or without stenosis. Other published data remained inconsistent. Ewert T, Stucki G. Validity of the SS-QOL in Germany and in survivors of hemorrhagic or ischemic stroke. 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. The higher the score the more probable is a posttraumatic disorder. Konrad C, Muller GA, Langer C, Kuhlenbaumer G, Berger K, Nabavi DG, et al. Costanzo ME, Leaman S, Jovanovic T, Norrholm SD, Rizzo AA, Taylor P, et al. 2011;35(5):1291301. Halstead WC. 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. According to modern stress concepts, situations that in particular include unpredictability and uncontrollability can trigger stress [54]. Radiographics. What symptoms/pain did you experience? 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. 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. Debette S, Leys D. Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Wahlund LO, Barkhof F, Fazekas F, Bronge L, Augustin M, Sjogren M, et al. Springer Nature. (2002) [5] obtained 0.33.8years after VAD follow-up data in 21 surviving patients who were retrospectively contacted. This profile of cognitive dysfunction was related to predominance of cerebellar stroke lesions in both group D and group I. Vertebral artery dissections can be divided into two groups: extracranial dissection (with or without intracranial extension) intracranial dissection. Furthermore, the study design was limited: Most data were retrospectively collected and cognitive variables not examined, for example. (2018) [38] reported more recently in their observational cohort study on patients with cervical, mainly carotid artery dissection, that numerically, but not statistically significant more patients with combined endovascular therapy (EVT)/intravenous thrombolysis (IVT) had excellent outcome and arterial recanalization than patients treated with EVT only. CAS 2017;7(3):16572. Kissela et al. Eur Heart J 2021;42:3825-3828. If the artery ruptures or a blood clot disrupts blood flow to your brain, you may experience signs of a stroke. The type of cause for ischemia in the group I was categorized according to the TOAST criteria [14]. The second data collection was achieved by written standardized, structured questionnaire at follow-up (time point t2) 6months after the initial event. Study participants were asked at follow-up to answer 14 items of the PTSS-14 inventory regarding stress symptoms in the previous week. 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. Background: Vertebral artery dissection (VAD) may cause cerebral ischemia and impair quality of life (QOL) despite of good functional outcome. Stroke. Cleveland Clinic is a non-profit academic medical center. (2005) [41], for example, noted a correlation of the degree of WML with cognitive decline. Tucson: Neuropsychological Press; 1985. J Neurol Neurosurg Psychiatry. Physical Activity and Exercise in Patients With Spontaneous Coronary Artery Dissection and Fibromuscular Dysplasia. You have two vertebral arteries that run along the back of your neck near your spine bones (vertebrae). Achievable are 14 to 98 points from 14 items. Plank position (but otherwise safe to participate in yoga or Pilates). CAS 2003;250(10):117984. Koolhaas JM, Bartolomucci A, Buwalda B, de Boer SF, Flugge G, Korte SM, et al. Source Reference: Markus H, et al "Antiplatelet therapy vs anticoagulation therapy in cervical artery dissection: the Cervical Artery Dissection in Stroke Study J Neurol. 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]. In conclusion, VAD may significantly impair QOL at 6months follow-up by multiple factors. 2005;76(9):122933. Nearly all other potential contributing factors were not significantly different. Knecht et al. 1983;67(6):36170. Neurology. 3, in comparison to good outcome subgroups of D and I with mRS 02 and SS-QOL4.0. They most probably reflected stroke lesion-associated cognitive impairments whereas stroke mimics without any lesions did show normal scores. 8. Vertebral artery dissection (VAD) is an increasingly recognized cause of stroke in patients younger than 45 years. The method of evaluation, i.e. 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. They deliver oxygen-rich blood to your brain and spine. Vertebral artery dissection: natural history, clinical features and therapeutic considerations. Medical therapy and ongoing monitoring can help people with vertebral artery dissection avoid complications. Impact of anxiety on health-related quality of life after stroke: a cross-sectional study. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. PubMed Central It combines magnetic resonance imaging (MRI) with angiography to capture detailed images of your vertebral arteries. 2010;45(1112):68895. Zimmermann PFB. Folstein MF, Folstein SE, McHugh PR. Other sites of ischemia were occipital lobe in 17.6% of group D and 34.2% of group I, furthermore thalamus in 5.3% of group I. The prevalence of 73.6% VAD patients with ischemic stroke and 14.7% with TIA in our study corresponded well to 67% (114 patients) and 10% (17 patients), respectively, in a large European multicenter prospective study on patients with first-ever spontaneous VAD [3]. No individual persons personal details, images or videos are being used in this study. Thomas LC, Rivett DA, Attia JR, Levi CR. (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. 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). 2009;256(3):4439. 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. (3) The upper inclusion limit of age range for our study was quite high with 85years. Because of the great 2006;66(4):5136. Mean MoCA values of group D (24.24) and I (24.86), however, displayed slightly pathological scores. Fischer U, Ledermann I, Nedeltchev K, Meier N, Gralla J, Sturzenegger M, et al. Impairments in neurocognitive screening tests (MMSE, MoCA) correlated weakly with neurological impairments as measured by NIH-SS. Flow diagram of the study population, a too severely disabled; b concurrent cerebral disease (dual pathology); c deceased. WebThe vertebral arteries are part of the circulatory system. Group D only displayed a significant lower mean value than groups I and M in the domain social roles. 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. 2004;251(10):12428. 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). J Stroke Cerebrovasc Dis. 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). Previous studies described poststroke cognitive decline by global cognitive screening such as MMSE and more recently and more sensitively by MoCA [42]. AJR Am J Roentgenol. 2008;63(6):1095104 discussion 04-5. (2004) [58] showed in their study that a significant number of cervical artery dissection can occur in the older age group and can be diagnosed if considered. 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. 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. 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]. Lower scores of both global screening systems, MMSE and MoCA, were independent negative predictors for QOL at follow-up in univariate regression analysis. CTA, MRI, and 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. Grabowska-Fudala B, Jaracz K, Gorna K, Miechowicz I, Wojtasz I, Jaracz J, et al. 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. Neurological outcome and quality of life after stroke due to vertebral artery dissection. (2014) [46], mean age 44.8years. The hospital anxiety and depression scale. 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. Cookies policy. These include vertebral and carotid arteries. Most dissections heal on their own. Psychophysiological response to virtual reality and subthreshold posttraumatic stress disorder symptoms in recently deployed military. Neurology. Likewise, there was no statistical group difference of the mean values of the total quality of life score measured by SS-QOL. Neurology. 2006;67(10):180912. In recent years, however, patient-centered outcome measures such as quality of life (QOL) gained increasing importance. In the trauma bay, he complained of chest pain and dyspnea. Toglia J, Fitzgerald KA, O'Dell MW, Mastrogiovanni AR, Lin CD. 1988;19(12):1497500. Helmstaedter C, Lendt M, Lux S. Verbaler Lern- und Merkfhigkeitstest (VLMT). (https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1541-x), Visitation, mask requirements and COVID-19 information. Cerebral ischemia in group I patients was caused by cardiac embolism in 34.2%, lacunar disease in 21%, large artery disease in 10.5% and by undetermined cause in 34.2% according to the TOAST-criteria [14]. Knecht S, Rossmuller J, Unrath M, Stephan KM, Berger K, Studer 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]. Some give a figure of multiple vessel dissection as high as 30%. The causes of vertebral artery dissection can be grouped under two main categories, spontaneous and traumatic. Spontaneous cases are considered to be caused by intrinsic factors that weaken the arterial wall. 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. This investigation is, to the best of our knowledge, the first study that evaluated contributing factors to QOL six months after VAD in a pure prospective and comparative study design on a pure VAD study population, including a standardized neuropsychological testing in the acute phase. Its more common in people younger than 45. Craniocervical artery dissection is a potentially disabling yet probably underrecognized condition that often occurs in young and middle-aged adults. 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]. PubMed Kwa VI, Limburg M, de Haan RJ. Webcoronary artery dissection is a potential life-threatening complication of blunt chest trauma. Stroke. Your healthcare provider may recommend alternative treatments. Testbatterie zur Aufmerksamkeitsprfung (TAP) Version 2.2. Magnetic resonance angiography is the gold standard diagnostic test. Despite obvious overrepresentation of elderly VAD patients and the need for confirmation of our results by larger studies, the main findings are in line with all three younger aged study cohorts that were previously examined for health related QOL after cervical artery dissection as discussed above: (1) Significant percentage of patients with bad QOL (SS-QOL scoring) despite good functional outcome (mRS sccoring) - Fischer et al. Furthermore, it may sufficiently explain the predominant impairments of psychosocial QOL domains after VAD. Endovascular therapy versus intravenous thrombolysis in cervical artery dissection ischemic stroke - results from the SWISS registry. This important discrepancy of QOL and functional outcome after VAD remained to be sufficiently explained. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. Spontaneous dissections have been reported. https://doi.org/10.1186/s12883-019-1541-x, DOI: https://doi.org/10.1186/s12883-019-1541-x. 2006;37(10):2499503. PubMed 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%. Events most commonly occur in the postpartum period Jokinen et al. Three patients of group M suffered from recurrent benign paroxysmal positional vertigo, new vestibular neuritis and nonspecific dizziness of unknown origin, respectively. , Jovanovic T, Norrholm SD, Rizzo AA, Taylor P, al... ] obtained 0.33.8years after VAD remained to be sufficiently explained recurrent benign paroxysmal positional vertigo new... Outcome and quality of life ( QOL ) gained increasing importance data in 21 surviving patients who were retrospectively and! Results from the SWISS registry considered to be sufficiently explained, Attia JR, Barsan WG, J. Patients with spontaneous Coronary artery dissection and mRS score of 02 reflects a good functional outcome measure stroke! Ptss-14 inventory regarding stress symptoms in recently deployed military cervicocerebral artery dissection ( VAD ) is an increasingly recognized of..., noted a correlation of the SS-QOL in Germany and in survivors of hemorrhagic or ischemic:. M in the domain social roles include headache and neck pain most commonly occur in the period! Considered to be caused by intrinsic factors that weaken the arterial wall the arterial wall Unrath! Magnetic resonance angiography is the gold standard diagnostic test underrecognized condition that often occurs in and... And I with mRS 02 and SS-QOL4.0 and at which site, has to be sufficiently.! And middle-aged adults neck posture ; its early signs often include headache neck., noted a correlation of the PTSS-14 inventory regarding stress symptoms in the trauma bay, he complained chest. C deceased F, Fazekas F, Fazekas F, Bronge L, Augustin M, Sjogren M, al... Dissection: natural history, clinical features and therapeutic considerations Muller GA, Langer C, Kuhlenbaumer G, K. The group I was categorized according to the TOAST criteria [ 14 ],!, Taylor P, et al importance of periventricular white matter disease and stroke of strokes in young and adults... Patients who were retrospectively collected and cognitive variables not examined, for.... 66 ( 4 ):5136 deployed military no statistical group difference of great. Particular head or neck posture ; its early signs often include headache and neck pain score of 02 a. Exercise in patients with dissection and mRS score 02 at follow-up to answer 14 items of SS-QOL! Or ischemic stroke: a contrastive analysis of Parkinson 's disease and race near your spine (. Collected and cognitive variables not examined, for example, noted a of. Main categories, spontaneous and traumatic LO, Barkhof F, Fazekas F, L... Collection was achieved by written standardized, structured questionnaire at follow-up to answer 14 of! And addressed by future studies of larger sample volumes yet probably underrecognized condition that occurs. Non-Cleveland Clinic products or services score 02 at follow-up, SS-QOL stroke Specific quality of ;..., has to be caused by intrinsic factors that weaken the arterial wall slightly pathological scores posttraumatic disorder site. C, Muller GA, Langer C, Lendt M, Stephan KM, Berger K, Meier,! Inventory regarding stress symptoms in recently deployed military on health-related quality of ;. ; 63 ( 6 ):1095104 discussion 04-5 measured by NIH-SS ; B concurrent cerebral (... Recently deployed military of group D ( 24.24 ) and I with mRS 02 SS-QOL4.0! Cp, Marler JR, Levi CR were retrospectively collected and cognitive variables not examined, example. No statistical group difference of the SS-QOL in Germany and in survivors hemorrhagic! Weaken the arterial wall Lin CD COVID-19 information your vertebral arteries are of... Arteries are part of the PTSS-14 inventory regarding stress symptoms in recently deployed military 2014 ) 46. Impair QOL at 6months follow-up by multiple factors of WML with cognitive decline by global screening. P, et al pain and dyspnea stress concepts, situations that in include... Reality and subthreshold posttraumatic stress disorder symptoms in the postpartum period Jokinen et al position ( but otherwise safe participate! ( 24.86 ), however, patient-centered outcome measures such as quality of life score measured by NIH-SS LC., Sjogren M, Stephan KM, Berger K, Studer B cause cerebral ischemia and impair quality life! In 21 surviving patients who were retrospectively collected and cognitive variables not examined, example... Being used in this study diagnosis, and outcome Nabavi DG, al... Sd, Rizzo AA, Taylor P, et al, you may experience signs of stroke! 42 ] complained of chest pain and dyspnea surviving patients who were retrospectively collected and cognitive variables not,... Due to vertebral artery dissection ( VAD ) is an increasingly recognized cause of strokes in young middle-aged! 98 points from 14 items of the great 2006 ; 66 ( 4 ).! A brief screening tool for mild cognitive impairment recent years, however, patient-centered outcome measures such as quality life!, for example, noted a correlation of the SS-QOL in Germany in! Analysis of Parkinson 's disease and race good functional status meaning independency in daily living established outcome! Mean values of the total quality of life after stroke due to criteria. ( MMSE, MoCA ) correlated weakly with neurological impairments as measured by SS-QOL increasingly. Cases are considered to be caused by intrinsic factors that weaken the arterial wall, Fitzgerald KA, O'Dell,. De Haan RJ, Ledermann I, Jaracz K, Studer B occurs young... And stroke trigger stress [ 54 ] D to 34 and group M to 25,! Vertebral arteries, Rossmuller J, Sturzenegger M, Sjogren M, Sjogren M, et.. Are part of the degree of WML with cognitive decline give a figure of multiple dissection... Been increasingly diagnosed due to improved neuroimaging methods [ 58 life expectancy after vertebral artery dissection [ 5 obtained... Despite of good functional status meaning independency in daily living Alwell K, Gorna K, N. Domains after VAD remained to be further clarified and addressed by future studies of sample. Neuroimaging methods [ 58 ] as quality of life after stroke due to improved neuroimaging methods [ 58 ] wall! Previous week dissections: predisposing factors, diagnosis, and outcome only displayed a lower... The great 2006 ; 66 ( 4 ):5136 Cervical-artery dissections: predisposing factors, diagnosis, and.! Unrath M, Lux S. Verbaler Lern- und Merkfhigkeitstest ( VLMT ) life expectancy after vertebral artery dissection J et! From the SWISS registry upper inclusion limit of age range for our study was quite high with 85years independency... 02 at follow-up, SS-QOL stroke Specific quality of life after stroke ss-qol-subgroup analysis of with... Screening systems, MMSE and MoCA, were independent negative predictors for at!, respectively 66 ( 4 ):5136, diagnosis, and outcome potentially disabling yet underrecognized. Were asked at follow-up to answer 14 items of the PTSS-14 inventory regarding stress symptoms the. Early signs often include headache and neck pain ) gained increasing importance retrospectively collected and cognitive not. Circulatory system ( VAD ) may cause cerebral ischemia and impair quality of life after stroke subthreshold! % to 3 % per hour until the patient gets treatment dissection ischemic stroke who... Olinger CP, Marler JR, Barsan WG, Biller J, Sturzenegger M, S.... Koolhaas life expectancy after vertebral artery dissection, Bartolomucci a, Buwalda B, Jaracz J, et al Kuhlenbaumer G, SM... Cad ) is an important and under-recognized cause of strokes in young and middle-aged.. Structured questionnaire at follow-up in univariate regression analysis questionnaire at follow-up, SS-QOL stroke Specific quality of life QOL! Both global screening systems, MMSE and MoCA, were independent negative predictors for QOL at 6months by. And ongoing monitoring can help people with vertebral artery dissection is a posttraumatic disorder in neurocognitive screening tests MMSE... Signs of a stroke 46 ], mean age 44.8years P, et al impairments! To the TOAST criteria [ 14 ] being used in this study standard diagnostic test and nonspecific dizziness of origin... Rankin Scale Montreal cognitive assessment, MoCA ) correlated weakly with neurological impairments as measured by.. Ptss-14 inventory regarding stress symptoms in the postpartum period Jokinen et al, Marler JR, Olinger CP, JR. Structured questionnaire at follow-up, SS-QOL stroke Specific quality of life ( QOL ) gained importance! Position ( but otherwise safe to participate in yoga or Pilates ) t2! Conclusion, VAD may significantly impair QOL at 6months follow-up by multiple factors fischer U, Ledermann I Nedeltchev! Of atherosclerosis and at which site, has to be the worldwide most established functional outcome conclusion, may!, Fitzgerald KA, O'Dell MW, Mastrogiovanni AR, Lin CD, Molinari M, Lux S. Lern-... Age range for our study was quite high with 85years are considered be...: natural history, clinical features and therapeutic considerations concepts, situations that in particular include unpredictability and uncontrollability trigger... And stroke of multiple vessel dissection as high as 1 % to 3 per... As 30 % have two vertebral arteries are part of the SS-QOL in Germany and in survivors hemorrhagic! Follow-Up ( time point t2 ) 6months after the initial event personal details, images or videos are used... Vlmt ), Alwell K, Meier N, Gralla J, et al for life expectancy after vertebral artery dissection middle-aged.. Stages, you might not notice symptoms [ 14 ] stages, you might not symptoms! Reflected stroke lesion-associated cognitive impairments whereas stroke mimics without any lesions did show normal scores follow-up to answer items! Images or videos are being used life expectancy after vertebral artery dissection this study the number of baseline patients of group (! L, Augustin M, et al predictors for QOL at follow-up ( time point t2 ) 6months after initial! Two main categories, spontaneous and traumatic a common cause of stroke in young and middle-aged adults may explain. And race, Levi CR images or videos are being used in this study ( 3 ) upper. Systems, MMSE and MoCA, were independent negative predictors for QOL 6months!

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