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Title: Cervical artery dissection : current concepts
Author: Menon, Ranjith Krishna
ISNI:       0000 0004 6057 6765
Awarding Body: St George's, University of London
Current Institution: St George's, University of London
Date of Award: 2015
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Cervical Artery Dissection: Current Concepts Cervical artery dissection is an important cause of ischemic stroke in the young, accounting for at least 30% of ischemic stroke in patients younger than 45 years. The knowledge on etiology, pathogenesis, preference of diagnostic imaging modality and treatment option on cervical artery dissection for the most part, is poorly understood. In my thesis I discuss the current available data on etiology, pathogenesis, clinical and radiological characteristics and treatment options in cervical artery dissection. In this thesis I performed a postal survey to understand the practice on patients with cervical artery dissection in the United Kingdom. Also to establish evidence based treatment in cervical artery dissection separate systematic reviews were performed to determine the safety and therapeutic effectiveness of medical treatment and interventional treatment in cervical artery dissection. The medical arm included studies comparing anticoagulants versus antiplatelets with following study end points of stroke and death. The results obtained from the survey were compared with a similar Canadian study and this showed prevalent ambiguity in the choice of best antirthrombotic treatment in cervical artery dissection. Also the results from the systematic review showed no difference in the efficacy or complications between antiplatelet and anticoagulant therapy. There were no prospective evidence based study establishing the role of thrombolytic treatment and stenting in cervical artery dissection. I also performed a retrospective study on patients diagnosed with cervical artery dissection at St Georges between January 1995 and August 2007. The aim of this study was to identify any radiological and/or clinical markers which may help predict future neurological events. The outcomes from this study were compared with data obtained from 3 other large published studies on cervical artery dissection. The occurrence and the association of pseudoaneurysms in cervical artery dissection were also studied. Cervical Artery Dissection in Stroke Study (CADISS) is a multicentre randomized, prospective feasibility study comparing antiplatelet treatment with anticoagulant treatment in patients with acute cervical artery dissection.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available