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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of the spontaneous dissecting aneurysm (SDA) of the cervical carotid artery (ICA) were reported. Case 1: A 36 years old man was admitted with a sudden onset of right hemiparesis, aphasia and a one-week history of headache and neck pain. Serological examinations were normal. Angiography showed a severe stenosis with two intimal flaps of the left cervical ICA. Four weeks later, left STA-MCA anastomosis was performed. After six weeks from the onset, re-angiography showed the resolution of the left cervical ICA stenosis. Case 2: A 26 years old man experienced the transient monoocular blindness a week before admission. He was admitted with a sudden onset of right hemiparesis and aphasia. Serological examinations were normal. Angiography showed a postsinus tapering occlusion of the left cervical ICA. Four weeks later, left STA-MCA anastmosis was performed. After the operation, left hemiparesis improved remarkably. After two weeks from the operation, re-angiography showed the complete resolution of the left cervical ICA stenosis. As the differential diagnoses, spasm, arteritis, embolism and thrombosis with atherosclerosis were listed. But from the reason reported, we diagnosed the two cases as the resolution of the SDA of the ICA. From the previous literature, 129 cases of SDA of the ICA were reviewed and discussed about the symptom, angiographic findings and treatment. Some specific findings (high frequency of resolution, 87%, etc.) were found. SDA of the ICA occurs in the non-atherosclerotic age and causes the ischemic brain damage. SDA of the ICA should be paid more attention and will probably be identified more frequently.
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PMID:[Spontaneous dissecting aneurysm of the cervical internal carotid artery. Report of 2 cases and review of literature]. 652 29

A 49-year old employee of a drug store with neck pain, painful thyroid gland, and elevated erythrocyte sedimentation rate (38 mm/h) was diagnosed as subacute thyreoiditis (de Quervain). However, application of oral corticosteroids (prednisone 50 mg/d) during three days did not reduce pain as expected. Therefore, the patient was admitted for further evaluation. Clinical examination showed a female in a pain-relieving posture (forward neck flexion). Further examinations including ultrasound of the thyroid, computertomography of the neck, and ENT examination did not reveal etiology of the pain. Finally, electrocardiography showed subacute infero-posterior myocardial infarction, and coronary angiography revealed severe coronary two vessel disease. Tabacco smoking since the age of fourteen (35 pack years) was identified as the only major risk factor for premature atherosclerosis. Diagnosis of subacute thyreoiditis is made from clinical and laboratory findings. Treatment with nonsteroidal antiinflammatory drugs or corticosteroids usually relieves pain within two or three days. Otherwise, etiology of the disease must be re-evaluated considering any disease localized in neck or thorax region. Antiinflammatory treatment of subacute thyreoiditis has to be continued for weeks or months.
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PMID:["Subacute thyreoiditis" without response on corticosteroid therapy]. 1594 Sep 11

Although cardiovascular mortality for men has been declining, the number of women dying from cardiovascular disease has slightly increased. Differences between women and men have been identified throughout the entire spectrum of ischemic heart disease, from risk factors to presentation and from diagnosis to treatment and outcomes. In the setting of an acute coronary syndrome or acute myocardial infarction, women are significantly more likely than men to report multiple non-chest pain symptoms, including dyspnea, nausea/vomiting, abdominal pain, back pain, neck pain, and jaw pain. Investigations into the pathophysiology of ischemic heart disease in women have broken away from the traditional thinking that coronary artery disease simply equals epicardial stenosis. In women, the new paradigm of coronary artery disease also focuses on diffuse atherosclerosis, endothelial dysfunction, and microvascular disease. Further research focusing on sex differences in cardiovascular disease is needed, but enough is currently known to offer a sex-based approach, which may ultimately lead to improved outcomes.
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PMID:Ischemic heart disease in women: an appropriate time to discriminate. 1760 24

This paper offers a contemporary, evidence-based perspective on the issue of adverse neurovascular events related to cervical spine manual therapy. The purpose of this perspective is to challenge traditional thought and practice and to recognize areas where practice and research should develop. By considering the themes presented in this paper, the clinician can broaden his or her approach to neurovascular assessment in line with contemporary evidence and thought. We present information based on clinically relevant questions. The nature of vertebrobasilar insufficiency and the utility of pre-treatment testing are examined in light of contemporary evidence. In addition, we report on internal carotid artery pathology, and the significance of appreciating atherosclerosis in clinical decision-making. These later two areas are not commonly recognized within manual therapy literature, and we suggest that their importance to differential diagnosis of head and neck pain, as well as estimating treatment related risk, is paramount. We propose that the term cervical arterial dysfunction is more appropriate than classically used nomenclature. This term refers more accurately and completely to the range of pathologies at different anatomical sites that manual therapists treating patients with head and neck pain are likely to encounter. Finally, we present a brief review of the medico-legal status pertaining to this area. Although this is English law-related, the themes derived from this section are of interest to all manual therapists.
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PMID:Manual therapy and cervical arterial dysfunction, directions for the future: a clinical perspective. 1911 83

Large vessel vasculitis leads to arterial wall thickening and stiffening because of chronic inflammatory changes. The cardio-ankle vascular index (CAVI) is recently utilized for assessing arterial stiffening caused by atherosclerosis-related diseases, including hypertension and diabetes, as well as aging. CAVI is mathematically calculated from stiffness index beta, which is established as a parameter of arterial stiffness independent of blood pressure. However, there are no data regarding arterial stiffness assessed by CAVI for large vessel vasculitis. We describe a patient with large vessel vasculitis who showed aortic wall thickening and increased CAVI without hypertension. A 68-year-old woman presented at our hospital with recurrent fever of 2-month duration, fatigue, neck pain, and weight loss. The images of 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) demonstrated significant 18FDG uptake (indicating increased metabolic activity and presence of inflammation) in the aorta and its major branches, including the carotid and subclavian arteries. Contrast-enhanced magnetic resonance imaging demonstrated wall thickening of the thoracic aorta. These imaging findings resulted in the diagnosis of large vessel vasculitis. The patient showed normal brachial blood pressure (right, 122/72 and left, 121/66 mmHg). However, CAVIs on both sides (right, 10.3 and left, 10.4) were elevated (normal value for her age, 9.1 +/- 0.8). In conclusion, arterial stiffness in patients with large vessel vasculitis may be increased because of the arterial wall thickening and inflammatory changes. Thus, CAVI may be promising for detection of increased arterial stiffness in patients with large vessel vasculitis in the early stage, in which blood pressure is normal.
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PMID:Detection of increased arterial stiffness in a patient with early stage of large vessel vasculitis by measuring cardio-ankle vascular index. 1977 26

A 71-year-old man presented with acute, right-sided neck pain and marked falls in blood pressure in response to cervical extension/rotation. Enhanced CT of the right carotid artery showed wall thickening and soft tissue enhancement surrounding the vessel. Ultrasonography demonstrated wall thickening and marked acceleration of the blood flow velocity. [18F] fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)-CT revealed increased FDG activity in the area of the right carotid bulb. The patient's symptoms resolved in 2 weeks with nonsteroidal anti-inflammatory drug; regression of wall thickening and decreased velocity were observed on follow-up ultrasonography. A carotid inflammatory process due to carotidynia in addition to atherosclerosis may increase carotid sinus baroreceptor stimulation, resulting in the onset of carotid sinus hypersensitivity.
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PMID:[A case of carotidynia with carotid sinus hypersensitivity]. 2106 51

True extracranial carotid artery aneurysms (ECCAs) are uncommon. Atherosclerosis is the most common etiological factor. Neck pain, a pulsatile mass and murmur at auscultation are the most common symptoms. ECCAs may exhibit severe clinical manifestations due to complications. Cases of rupture can be fatal. There is a risk of distal embolization and stroke in thrombosed cases. We discuss two cases of enlarged ECCA treated surgically in the light of the most recent literature.
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PMID:True Aneurysms of the Extracranial Carotid Artery : An Evaluation of Two "Giant Aneurysms" and the Current Literature. 2952 73

A 65-year-old Japanese man with bilateral carotid atherosclerosis presented with right neck pain and fever. Contrast-enhanced computed tomography suggested carotid arteritis, and carotid ultrasonography showed an unstable plaque. The patient developed a cerebral embolism, causing a transient ischemic attack. Helicobacter cinaedi was detected in blood culture, and H. cinaedi-associated carotid arteritis was diagnosed. Empirical antibiotic therapy was administered for 6 weeks. After readmission for recurrent fever, he was treated another 8 weeks. Although the relationship between H. cinaedi infection and atherosclerosis development remains unclear, the atherosclerotic changes in our patient's carotid artery might have been attributable to H. cinaedi infection.
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PMID:Helicobacter cinaedi-associated Carotid Arteritis. 2967 69