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Aberrant anatomical variation of the vertebral artery (VA) from an internal carotid artery (ICA) is considered a rare finding. The incidence of this phenomenon can lead to patients suffering from posterior circulation neurological deficit if the ICA becomes significantly diseased. VA atypical anatomical origin is considered one of the rare pathologies, not only precipitating neurovascular incidents but equally leading to severe difficulty in VA dissection and surgical exposure, especially in carotid artery procedures.
View Article and Find Full Text PDFChallenges and Advances in Management of Acute Isolated Extracranial Internal Carotid Artery Occlusions.
Radiology
January 2025
From the Departments of Neurosurgery (B.J.D., N.C.), Radiology (N.C.), Neurology (N.C.), and Otorhinolaryngology (N.C.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109.
Extracranial Thrombosed Vertebral Aneurysm Associated Neurofibromatosis Type1 Treated by Neuroendovascular Coil Embolization: A Case Report and Review of Literature.
Clin Case Rep
January 2025
Department of Neurosurgery, School of Medicine Yamagata University Yamagata Japan.
A 46-year-old NF1 patient with sudden visual disturbance had a thrombotic vertebral artery aneurysm causing cerebral infarction. Endovascular internal trapping was performed successfully, with complete recovery and no neurological deficits. Although this is a rare case, it suggests that endovascular therapy could be successful for vascular lesions complicated by NF1.
View Article and Find Full Text PDFDetermining the Optimal Age for Extracranial-Intracranial Bypass Surgery: A Post Hoc Analysis of the CMOSS Randomized Trial.
Stroke
December 2024
Department of Neurosurgery and Interventional Neuroradiology, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical University, National Center for Neurological Disorders, Beijing, China. (L.J.).
Background: Previous trials have failed to demonstrate the benefits of extracranial-intracranial (EC-IC) bypass surgery for patients with carotid or middle cerebral artery occlusion. However, little evidence has focused on the effect of age on prognosis. This study aimed to explore whether EC-IC bypass surgery can provide greater benefits than medical therapy alone in specific age groups.
View Article and Find Full Text PDFEarly vs Late Anticoagulation After Ischemic Stroke in Patients With Atrial Fibrillation and Covert Brain Infarcts.
Neurology
January 2025
Department of Neurology, University and University Hospital Basel, Switzerland.
Background And Objectives: Covert brain infarcts (CBIs) in patients with first-ever ischemic stroke (IS) and atrial fibrillation (AF) are associated with an increased risk of stroke recurrence. We aimed to assess whether CBIs modify the treatment effect of early vs late initiation of direct oral anticoagulants (DOACs) in patients with IS and AF.
Methods: We conducted a post hoc analysis of the international, multicenter, randomized-controlled ELAN trial, which compared early (<48 hours after ischemic stroke for minor and moderate stroke, 6-7 days for major stroke) vs late (>48 hours for minor, 3-4 days for moderate, 12-14 days for major stroke) initiation of DOACs in patients with IS and AF.
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