Subgroup analysis yielded significantly higher scores for posttraumatic stress symptoms (p=0.002) in this subgroup. Provided by the Springer Nature SharedIt content-sharing initiative. Incidence and outcome of cervical artery dissection: a population-based study. 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]. The mRS is considered to be the worldwide most established functional outcome measure after stroke. For more extensive testing, a neuropsychological test battery was used with cognitive tasks of nine cognitive domains with possible reference to cognitive functions of the anatomical structures of the posterior circulation, in particular the cerebellum. The Neurological Institute is a leader in treating and researching the most complex neurological disorders and advancing innovations in neurology. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. (2009) [6], mean age 46years, Czechowsky et al. The PTSS-14 was developed by Twigg et al. MoCA, to our best knowledge, was used in our study for the first time in VAD patients. GA compendium of neuropsychological tests. Eur J Radiol. Twenty-three patients with VAD had (subtotal) occlusion, eight patients a stenosis and three no significant stenosis. Endovascular therapy versus intravenous thrombolysis in cervical artery dissection ischemic stroke - results from the SWISS registry. Terms and Conditions, 2008;52(2):2028. No further differences were found in the other domains. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Group-related mean values were below this cut-off level and not significantly different between groups: group D 27.1513.10, group I 23.848.74, and group M 26.129.55. Jokinen H, Kalska H, Mantyla R, Ylikoski R, Hietanen M, Pohjasvaara T, et al. Foa E, Cashman L, Jaycox L, Perry K. The validation of a self-report measure of posttraumatic stress disorder: the posttraumatic diagnostic scale. Spontaneous dissection of the carotid and vertebral arteries. 1975;12(3):18998. The overrepresentation of elderly patients in our study may be most probably explained to some extent by a hospital-based selection bias: (1) Patients were recruited when referred to the supraregional stroke unit of our teaching hospital. Radtke FM, Franck M, Drews T, Weiss-Gerlach E, Twigg E, Harbeck-Seu A, et al. Comparison of cognitive baseline profiles of the three groups revealed no significant differences. A Spearmans rank correlation analysis was performed for outcome-relevant variables. In recent years, however, patient-centered outcome measures such as quality of life (QOL) gained increasing importance. They assessed, partly retrospectively two months to five years, partly prospectively one month after dissection, the presence of PTSD by using the Posttraumatic Diagnostic Scale (PDS) as self-rating questionnaire. Leys D, Debette S. Long-term outcome in patients with cervical-artery dissections: there is still a lot to know. Although there was a preponderance of atrial fibrillation in group I, no significant group differences of neurovascular risk factors were found in line with current knowledge about VAD characteristics [3, 35]. Knecht S, Rossmuller J, Unrath M, Stephan KM, Berger K, Studer B. Coping with chronic neurological impairment: a contrastive analysis of Parkinson's disease and stroke. I was unable to return to work for three months. Likewise, there was no statistical group difference of the mean values of the total quality of life score measured by SS-QOL. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. 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). 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. Neuropsychologia. PubMed Psychological variables such as pre-baseline symptoms of anxiety and depression were not significantly different between our groups. Google Scholar. The latter one was also used to determine the functional outcome at follow-up, filled out by the patient. We thank Dr. Werner Wosniok from the Institute of Statistics at the University of Bremen, Bremen, for his statistical advice. A summary score of 4.0 was considered to indicate good QOL, a score3.9 bad QOL in accordance with Fisher et al. Article Vertebral artery dissection is a rare cause of stroke in older adults. 2005;1(1):5968. 1997;9:44551. A practical method for grading the cognitive state of patients for the clinician. This important discrepancy of QOL and functional outcome after VAD remained to be sufficiently explained. Intergroup analysis of change of mean total scores of QOL, as measured by SS-QOL, from pre-baseline to follow-up displayed a significant deterioration (p<0.001; Wilcoxon signed-rank test) in groups D and I but not in group M. Further analysis of changing scores in the twelve SS-QOL domains yielded developing impairments from baseline to follow-up in all three groups D, I, and M. Impairments evolved mainly in psychosocial domains such as family roles, social roles and energy and less in physical domains. The aim of this study was therefore as follows: (1) to evaluate the characteristics of patients after VAD with special focus on those with bad quality of life despite good functional outcome in comparison with positive and negative control patients in a prospective comparative study design (2); to identify contributing factors to quality of life after VAD, considering neurological, cognitive, and psychological variables (3); to identify the predictive factors for quality of life after VAD. Helmstaedter C, Lendt M, Lux S. Verbaler Lern- und Merkfhigkeitstest (VLMT). The variance of total QOL was determined by neurological, neurocognitive and psychological predictive factors. The findings were in line with modern concepts of cerebellar cognitive function [44] and also in accordance to previous data on cognitive impairments in patients with cerebellar stroke lesions, for example by Exner et al. Depressive symptoms in stroke patients treated and non-treated with intravenous thrombolytic therapy: a 1-year follow-up study. VAD affected the right side in 13 patients (38.2%), the left side in 18 patients (53%), and both sides in three patients (8.8%). Ewert T, Stucki G. Validity of the SS-QOL in Germany and in survivors of hemorrhagic or ischemic stroke. Monitoring typically includes magnetic resonance angiography every three to six months. Hemorrhagic stroke was found to result in a lower survival rate or lower level of functionality than ischemic stroke. Consequently, a valid and reliable evaluation of this variable as putative contributing factor appeared to be not adequately possible in our study: Besides the sample size being very small, it remains unclear how to operationalize best the vascular measurements such as (1) determination of grade/severity of stenosis and by which method (MRI or ultrasound), (2) length of stenosis or occlusion, or (3) site of stenosis (unilateral left or right, bilateral, additionally extra-vertebral). Traenka C, Dougoud D, Simonetti BG, Metso TM, Debette S, Pezzini A, et al. Living With Whats it like living Vertebral artery dissections can be divided into two groups: extracranial dissection (with or without intracranial extension) intracranial dissection. 2009;256(3):4439. 1977;86(2):10326. Study participants were asked at follow-up to answer 14 items of the PTSS-14 inventory regarding stress symptoms in the previous week. These are typically among the first tests people receive. 2004;75(8):11946. A 42-year statement and A total score11 out of 14 items corresponds to a pathological result, a score between 8 and 10 means a suspect result. CTA, MRI, and Stroke. The aim of this study was the multimodal analysis of patient characteristics after VAD to identify contributing factors. At least 90 percent of adults with FMD are women. Arnold M, Bousser MG, Fahrni G, Fischer U, Georgiadis D, Gandjour J, et al. 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). Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J, et al. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. By means of linear regression analysis, we first calculated the predictive value of certain variables for the variance of SS-QOL scores at follow-up in an univariate model. Kissela B, Lindsell CJ, Kleindorfer D, Alwell K, Moomaw CJ, Woo D, et al. (2009) [6] prospectively found 3793455days after event 30% patients with impaired SS-QOL scoring among 66% with favorable functional outcome (mRS01) in a mixed series including patients with VAD and patients with ICAD. Individuals facing a higher risk of future dissection will need follow-up care for many years. Source Reference: Markus H, et al "Antiplatelet therapy vs anticoagulation therapy in cervical artery dissection: the Cervical Artery Dissection in Stroke Study Grond-Ginsbach et al. Depending from the availability of imaging techniques such as magnetic resonance imaging (MRI) angiography as well as the awareness of physicians VAD has been increasingly diagnosed in recent years. Secondary exclusion due to defined criteria decreased the number of baseline patients of group D to 34 and group M to 25. Konrad C, Muller GA, Langer C, Kuhlenbaumer G, Berger K, Nabavi DG, et al. Otherwise, antithrombotic therapy was This option is also for people with hemorrhagic stroke. Patients with suspected cervical artery dissection received additional angiography, mainly MRI angiography, if there has not been already evident cranial computer tomography or even conventional angiography. 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). (2002) [5], mean age 50years, (2) posttraumatic stress symptoms as significant predictor for reduced SS-QOL Speck et al. 1987;149(2):3516. It can also lead to swelling (dilation) of the artery. Privacy [13] and in the context of a fitting medical history, i.e. Gttingen: Beltz Test GmbH; 2001. Cognitive baseline profiles of the PTSS-14 inventory regarding stress symptoms ( p=0.002 ) in this.! Life ( QOL ) gained increasing importance variables such as pre-baseline symptoms anxiety! 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