Combined Oral Contraceptives Bringing to Light May-Thurner Syndrome.

May-Thurner syndrome (MTS) is a relatively uncommon clinical condition characterized by venous blockage in the left lower leg. Compression of the left common iliac vein by the right common iliac artery and the underlying vertebral body causes obstruction. We report a case of MTS with extensive venous thrombosis in a 44-year-old female who remained clinically silent until she used combined oral contraceptive pills (OCPs) for more than three years.

Vertebrobasilar Stroke: Association Between Infarction Patterns and Quantitative Magnetic Resonance Angiography Flow State.

Background Treatment and prognosis of vertebrobasilar atherosclerotic disease differs depending on stroke mechanism, such as artery-to-artery embolism, branch atheromatous disease, and hemodynamic ischemia. Our aim was to investigate the relationship between infarction pattern and flow status using quantitative magnetic resonance angiography (QMRA), to determine the validity of using infarction patterns to infer stroke mechanism. Methods and Results This is a retrospective study of patients with ischemic stroke with intra- or extracranial vertebrobasilar atherosclerotic stenosis, who underwent magnetic resonance imaging of the brain, neurovascular imaging, and QMRA, between 2009 and 2021.

Challenging the diagnosis of a posterior circulation dissecting aneurysm.

Introduction: I ntracranial vertebral dissections have polymorphs clinical presentations and can lead to haemorrhagic complications if they are intracranial. We here describe a case of a thrombosed dissecting aneurysm of postero-inferior cerebellar artery (PICA) revealed by a Wallenberg syndrome preceded by headaches.

Case: A 23-year-old patient, without neurological or vascular past medical history, was admitted for dizziness preceded by headache.

An Atypical Presentation of Left Lateral Medullary Syndrome - A Case Report.

Lateral medullary syndrome (LMS), known as Wallenberg's syndrome and posterior inferior cerebellar artery syndrome, is a rare cause of stroke. It often results from thrombosis or emboli of the vertebral artery or posterior inferior cerebellar artery. The triad of Horner's syndrome, ipsilateral ataxia, and ipsilateral hyperalgesia clinically identify patients with LMS.

Stent-Assisted Embolization for Acutely Ruptured Aneurysm.

Objective: The purpose of this study was to report the results of stent-assisted embolization performed at our hospital for acutely ruptured aneurysms.

Methods: This study consisted of 19 patients (4 men and 15 women) with acutely ruptured wide neck aneurysm who underwent stent-assisted coil embolization in acute stage between December 2016 and October 2020. Stent-assisted embolization in the acute stage was performed for very wide neck ruptured aneurysm only when balloon-assisted embolization was failed or was thought to be impossible.

A rare case of marijuana associated with ascending aorta thrombosis complicated with stroke and bilateral renal infarcts.

Ascending aortic is an uncommon site for arterial thrombosis and ascending aortic thrombosis is a very rare phenomenon with a high fatality rate. Marijuana is the most commonly used psychoactive drug in the United States and a few cases have been reported on the association of marijuana with vascular thromboembolism. However, the pathophysiology and exact mechanism are still not well studied.

[Vertebral artery thrombosis in a 7-year-old child].

Összefoglaló. Az agyi érrendszer elzáródásos panaszai elsősorban felnőttkorban jelentkeznek, nem ritkák azonban gyermekek esetében sem. A gyermekkori stroke gyakorisága 2,5/1 000 000 fő; ilyenkor általában az arteria carotis interna vagy az arteria cerebri media érintett.

Wilkie Syndrome and Pseudo-Nutcracker Syndrome a Rare Combination: Description of a Case.

Wilkie's syndrome is a very rare vascular alteration caused by congenital or acquired reduction of space between the superior mesenteric artery (SMA) and aorta. In acquired form, it is caused by perivascular adipose tissue reduction due to rapid weight loss and, if symptomatic, causes postprandial vomiting and weight loss. The left renal vein (LRV) when it has a retro-aortic course can be compressed in aorto-vertebral space (AVS); if the stenosis is severe it can cause venous congestion symptoms with left flank pain, microhematuria, and thrombosis, this vascular alteration is known as a pseudo-nutcracker syndrome.

Non-Standard Management of Target Vessels With the Inner Branch Arch Endograft: A Single-Center Retrospective Study.

Purpose: The purpose of this study was to evaluate early and mid-term results of non-standard management of the supraaortic target vessels with the use of the inner branch arch endograft in a single high-volume center.

Material And Methods: A single-center retrospective study including all patients undergoing implantation of an inner branch arch endograft from December 2012 to March 2021, who presented a non-standard management of the supraaortic target vessels (any bypass other than a left carotid-subclavian or landing in a dissected target vessel). Technical success, mortality, reinterventions, endoleak (EL), and aortic remodeling at follow-up were analyzed.

Vertebral artery dissection and associated ruptured intracranial pseudoaneurysm successfully treated with coil assisted flow diversion: A case report and review of the literature.

Dissecting intracranial pseudoaneurysms (IPs) are associated with a high incidence of rupture and poor neurologic outcomes. Lesions in the posterior circulation are particularly malignant and pose even greater management challenges. Traditional management consists of microsurgical vessel sacrifice with or without bypass.

Vertebral to Basilar Thrombus Migration Post Intravenous Thrombolysis.

Recombinant tissue plasminogen activator improves outcomes in acute ischemic stroke. Alteplase may result in thrombus migration (TM) distally to a critical arterial supply that can worsen perfusion to eloquent brain tissue. Alteplase-related stroke recanalization and clot migration in vertebral artery (VA) occlusion whereby the clot migrates to the basilar artery (BA) may be harmful.

Outcomes and Spectrum of Major Neurovascular Events Among COVID-19 Patients: A 3-Center Experience.

Background: Preliminary data suggest that Coronavirus Disease-2019 (COVID-19) is associated with hypercoagulability and neurovascular events, but data on outcomes is limited.

Objective: To report the clinical course and outcomes of a case series of COVID-19 patients with a variety of cerebrovascular events.

Methods: We performed a multicentric, retrospective chart review at our three academic tertiary care hospitals, and identified all COVID-19 patients with cerebrovascular events requiring neuro-intensive care and/or neurosurgical consultation.

Developments in distinguishing secondary vascular headache from primary headache disorders in clinical practice.

Introduction: Vascular headaches are secondary headache disorders with potentially devastating consequences if missed. Clinicians often struggle to distinguish these from primary headache disorders whereby there is no underlying structural pathology. Here, the authors describe the advancement in our understanding of vascular headache disorders, their clinical presentation and the developments in neuroimaging that facilitate diagnosis.

Recurrent in-stent thrombosis following V4 segment of vertebral artery stenting: A case report.

Introduction And Importance: We report a rare case of subacute recurrent in-stent thrombosis after vertebral artery stenting of the left intracranial segment.

Case Presentation: A 56-year-old man presented with V4 segment severe stenosis of the left vertebral artery. Stent (Apollo, 2.

A case report of quadriplegia and acute stroke from tracking retropharyngeal and epidural abscess complicated by necrotizing fasciitis.

A 59-year-old male presented to the emergency department complaining of severe posterior neck pain and progressive extremity weakness for 2 weeks. He was found to be quadriplegic with complete sensory and motor deficits at the C5 level and hypotensive. Diagnostic imaging revealed discitis/osteomyelitis at the C5-C6 and C6-C7 vertebral levels with multiple spinal epidural abscesses extending from C5-C7 with resulting severe spinal canal narrowing with cord compression.

May-Thurner Syndrome: A Case Report and a Concise Review.

We report a case of a 31-year-oldman who presented to the hospital with extensive deep vein thrombosis (DVT) complicated by pulmonary embolism (PE) after a recent trauma and prolonged immobilization. He underwent contrast venography that revealed features of May-Thurner syndrome (MTS). He was managed with therapeutic anticoagulation, inferior vena cava filter placement, mechanical clot aspiration, catheter-directed thrombolytic therapy, and left common iliac vein stenting.

Retrograde thrombectomy of basilar artery thrombus through the posterior communicating artery.

Transcirculation thrombectomy through the communicating arteries of the circle of Willis has been previously described as a bailout in cases where direct thrombectomy is not feasible.1-3 Here we present a unique case where a retrograde thrombectomy of the proximal basilar artery was performed using the right posterior communicating artery (PCOM) in a patient with bilateral occlusions of the vertebral arteries, believed to be chronic. This was done using a quadriaxial system with multiple concentric catheters to minimize the ledge effect and achieve smooth and safe transition of the catheters from anterior to posterior circulations.

A Never Described Variant of the Cervical Rib Causing Arterial Thoracic Outlet Syndrome: World's First Case.

Cervical ribs, also known as Eve's ribs, are rare and found in 1% of population. They are more common in females and more common on right side. They are asymptomatic in 90% of cases.

Microcatheter-Assisted Protection of the Posterior Inferior Cerebellar Artery During Parent Artery Sacrifice of a Vertebral Artery Dissecting Aneurysm.

Branch vessel occlusion is a major cause of stroke in parent artery sacrifice (PAS) for vertebral artery dissecting aneurysms (VADA). There is now an increasing trend towards preservation of branch vessels during PAS. Stents are commonly employed to achieve this but bring with it the attendant risks of future thrombosis and lifelong antiplatelet use.

Antithrombotic therapies in aortic and peripheral arterial diseases in 2021: a consensus document from the ESC working group on aorta and peripheral vascular diseases, the ESC working group on thrombosis, and the ESC working group on cardiovascular pharmacotherapy.

The aim of this collaborative document is to provide an update for clinicians on best antithrombotic strategies in patients with aortic and/or peripheral arterial diseases. Antithrombotic therapy is a pillar of optimal medical treatment for these patients at very high cardiovascular risk. While the number of trials on antithrombotic therapies in patients with aortic or peripheral arterial diseases is substantially smaller than for those with coronary artery disease, recent evidence deserves to be incorporated into clinical practice.

A Rare Case Report of Flexion Teardrop Cervical Fracture with Blunt Vertebral Artery Injury Leading to Stroke.

Non penetrating trauma to vertebral artery is a known complication in craniovertebral trauma. They are mainly reported with facet dislocations or injuries involving the foramen transversarium. Such a type of injury is rarely seen with flexion injuries.

May-Thurner syndrome: A cause of unexplained unilateral leg edema.

Physicians should be familiar with May-Thurner syndrome, characterized by the compression of the left common iliac vein by the right common iliac artery and the vertebral body, resulting in pain and swelling of the left lower extremity and DVT. A 64-year-old woman presented with unexplained edema in the left lower extremity. Computed tomography with contrast enhancement revealed that the left common iliac vein was compressed and narrowed by the right common iliac artery and the vertebral body, leading to the diagnosis of May-Thurner syndrome.

[Analysis of the effect of stent-assisted embolization for low-grade subarachnoid hemorrhage caused by V4 segment dissecting aneurysm of vertebral artery].

To investigate the efficacy and safety of different stents assisted embolization in the treatment of subarachnoid hemorrhage(SAH) caused by V4 dissecting aneurysm of vertebral artery. The clinical data of 39 patients with spontaneous SAH V4 dissecting aneurysm treated at the Department of Neurosurgery, the Northern Theater General Hospital from January 2016 to June 2019 were analyzed retrospectively.There were 21 males and 18 females, aged (48±17) years(range:35 to 68 years).

Routine Stent Bridging to the Supraaortic Vessels in Aortic Arch Replacement: 10-Year-Experience.

Background: The supraaortic vessel anastomosis stent bridging (SAVSTEB) technique simplifies the reattachment of the supraaortic vessels in aortic arch surgery; however, follow-up data are limited. The study aimed to investigate the stent-related performance and complications.

Methods: Between February 2009 and September 2020, 112 patients underwent total arch replacement with a tetrabranched graft and using the SAVSTEB technique.