Clarity, details, illustrations, explanations... Perfect. Thank you

Hey there! VAD survivor here. I see plenty of people asking if they have dissections or not both here and on our VAD group... To answer it simply, no one can answer this question apart your radiologist. There could be a whole myriad of other conditions that require medical investigation. If you will be referred to get imaging - other issues that could affect your neck will be checked too as mentioned by the author of this video - dissections are quite rare, but cervical herniated discs are not (it's just an example!). Please do not try to self-medicate as if you have an active intracranial dissection, you can easily cause a hemorrhagic event. Also, I had 0 symptoms during my dissection that spanned from V4 to V3. No pain, no discomfort. Until two days later after the trauma, I had two very symptomatic brainstem strokes... And I've met loads of people who had no symptoms as well and their dissection findings were incidental. Hope that makes any sense. Please don't waste your time waiting for someone to guess if you have this or not, if in doubt - check it out.

Young spanish neurologist here, this is just AWESOME, congrats and thanks so much!!! this is HBO neurology material

Wonderfully explained. Thank you!

8:21 symptomatic elongated styloid processes colloquially are also known as "Eagle's syndrome" (Classic/Vascular version), which is relatively rare and many doctors are not even aware of the condition... I'm really happy to see it being more and more recognised as the potential cause of lesions/dissections/impingements of blood vessels. Surgical resection/shortening of the styloid processes is an option too if they are in close proximity/contact with the ICA or even CCA in some cases. In some cases, elongated greater horns of the hyoid bone may cause dissections too

Thanks for your video,I had a spontaneous vertebral artery dissection and multiple strokes I wish more people new these symptoms

Brilliant presentation as always . Please make a video on higher mental functions .

Thank you for the EXCELLENT video. The BEST I have ever seen.

i cannot find the best words to thank you for this excellent presentation. Thank you for your precious time and your kindness Dr Rybinnik 😍😍😍😍😍😍😍😍

excellent video! please post more. Love the special effects

Really useful video. Helping me to prepare for my final exams of my Osteopathy degree. Thank you!

52 yo male in Sweden. Left side Horners (didn´t know what that was) and a mild headache was my only signs 9 days ago. Diagnosed with internal carotid dissection. Everything that was done to me and that the doctors told me, matches the facts and conclusions in this video. Kind of comforting.

Amazing thought-through lecture. Thank you.

Thank you. Very well explained.

Brilliantly presented and so good at summarizing a confusing area for so many in a very digestible way

You made neurology so interesting! Thank you

Currently experiencing a bilateral dissection myself. Would love to be a case study..4 hospital visits completely missed it. ENT diagnosed outpatient with CT Angiogram. Thanks for the great info..gives me hope for healing.

I absolutely love all of your videos. I'm currently working in a neurology office. It's definitely interesting.. and very complex.

Great presentation. This makes learning quite fun.

Great content! Thank you!

what`s this beautifull content!! thank you so much

I wound bay for more episodes 😢

Excellent video. Thank you!!

Thank you very much for the amazing presention! I hope you make an up-dated video on the treatment option assuming there is a 2021 AHA new treatment guidlines

amazing lecture! thank you for doing these great videos!

Thanks for the amazing lecture

Brilliant

The best. You are amazing 😻

amazing

very useful video. thank you

Duuuuude!!! Love the videos

What's the treatment 24:09 recommendations for uncomplicated vertebral artery dissections? Aspirin or Anticoagulants?

I was diagnosed "No acute ischemic injury. There are two areas of most conspicuous focal narrowing of the left common carotid artery, the narrowest spanning approximately 3 cm in length with an intramural hematoma best seen on the proton density sequence is consistent with focal dissection of the vessel with maximal luminal narrowing of approximately 60%. Proximally there is an intramural hematoma best seen on series 15, image 34." on 4-5-2023 at the ER. They discharged me and asked me to make an appointment with a neurologist within 2-3 days. I made 100 calls. The earliest appointment is in October. What should I do now? I used to play tennis 5 times a week. 2 hours a day. I am 53 years old. very fit.

Excellent presentation congratulations. I am an obstetrician and Gynecologist and i have a question for my self. I have recently experienced a VAD that was unilateral (LVAD) and a small ishemic stroke on the left region of medulla during my night shift in the hospital. It has been 5 months since then. I am 48 years old and i have no appreciable neurological damage. My recently CTA (2 months ago) shows that the vessel is still obstructed on V3. seagment. If the vessel recanalized how soon can i return to my athletic activities (running or sit ups)?

Hi, what do you mean by dissections having a low risk of stroke? I thought the literature said around 70% risk of stroke with carotid artery dissection? I’m just trying to understand the “generally a benign disease” part.

SNOOP: +Vertigo.

In which video do you talk about the different diagnostic imaging methods (CTA with contrast & MRA with contrast) in closer detail again? You said there are more info in your "Intro to stroke doc" (6:26), but not sure what video that refers to I am thinking about getting checked for this since I am having a continual head ache and had to deal with a weird feeling in the brain and nausea (but no pain, no neurological defects, no other symptoms), which I started having yesterday immediately after doing some intense exercises with a vibrating rod (in the excercise there are a lot of abrupt back-and-forth movements in the cervical spine because it has to stabilize the vibrations). I am 22 btw, otherwise healthy, but have some problems with my back (several protrusions, a diagnosed spinal syndrome) I waited whether it got better but it stayed there, so I went to an emergency clinlic. I was checked (blood values, blood pressure, ecg) and everything was normal, but I rejected a CTA because it felt like it was getting slightly better and I was put off by the many warnings about the radiation in the hospital. I don't know if I am overly cautious with regards to these, but I am hesitant because of the radiation in the CT and contrast mediums like gadolinum in MRAs. If it's necessary to have an early diagnosis that could be very valuable, it might obviously be worth it, but I dunno if my symptoms are too few to really warrant that. It might just be tight muscles in my neck for all I know that cause these headaches. I'll also go to my doctor to speak about this with her and get her recommendations today.

I missed Darth Vader in your presentation :)

Hi ! Thank you for this extremely informative video. I am 46 yo and otherwise very healthy and I suffered a right carotid dissection in january. I was told by the neurologist of a 90% blockage and I had vision loss of the right eye and extreme fatigue. I am only on aspirin, now finished with Plavix. My vision came back but I struggle to know what activities I should do. I tryed a little bit of gentle cycling, a tiny bit of gardening (not the same day) but as soon as I put an effort I feel pressure in my neck where the arthery is. I also ended up very tired after go back to 8-9 hours of sleep and a more active day. I was told my blockage had reduced to about 50% mid-february so I was expecting to be healed by now. Is this part of the normal recovery process? I couldn’t find information on what activities I was allowed to do at the beginning of my convalescence. I guess I am at a point where I just should increase efforts gradually? Thank you for any guidance or opinion.

Bonjour je me permet de vous poser la question en français: y a t il des precautions à prendre après cicatrisation d'une dissection de l'artère vertébrale ?

But.... 24:01 what is the treatment for the second case? since he had ataxia and both vertebral artery dissected and presented with ataxia, did he receive some surgery or just IV TPA ?

Clarification needed…. In a vertebral artery dissection with stenosis of v1 v2 and v4 , is the procedure stent or thrombi lysis?

Hi thanks for your video and for us non medical field it's also very informative. I had a chiro treatment/neck manipulation 2 weeks ago but I still have the sensation of "floating", tingling sensation mostly on my right arm and thickening sensation of my hands and feet, also feels weird in my right eye not having the usual acuity. There's also a pain in the back of the neck after the chiro and I am on Baclofen for 2 weeks and it seems helping though I still feel discomfort in my neck. CT scan is unremarkable and having just neck spasm as findings but I just consulted another neuro and she wants to rule out artery dissection and my schedule of MRA for neck is next week and results might take another couple of days. My question is since it's going 3 weeks now after the injury, any possibilities that there will be a worsening of damages if any as I'm not really starting the treatment if I really have a dissection? Is time of the essence right now? And do I have a high chance of having stroke while waiting for the diagnosis? Your response is really appreciated!

Really curious if this is what I have, but this has been going on for a few years. Back in 2019 i was on a ride at an amusement park that got weirdly wild out of no where and i banged my head around quick wildly Later that night i had a visual aura for the first time followed by what seemed like a migraine and nausea associated to a migraine. that went on until i got blue light glasses and reduced light but still happened every week or so, completely flooring me. Fast-forward to today, 2023 and I still get this but rarely. it is caused by light exclusively and wearing sunglasses outside of my bedroom at all times seemed to be the only way to remedy the onset of the aura, but now the aura comes followed by a loss of being able to speak or remember names or form sentences, a numbness in my arms and face and pain behind one eye and a really bad migraine once those symptoms subside (30 min to an hour later) The migraine lasts, a few hours and a dull headache is present for a few days afterword's. But this all started with the roller coaster back in 2019. I have been treating this like a migraine since that day but maybe the migraine is a symptom of this? But I have heard that this heals on its own after some time, it hasn't for me. Doctors I have gone too seem to treat this by saying, take advil when you get a migraine and leave it at that; but Maybe its all because I said I think its migraines from the looking into it that I did and they never fact checked me? What are your thoughts? really curious if this fits the build and ive been barking up the wrong tree these last few years, id really like if it was this because then i wouldn't feel like im essentially boned and left to just figure out this on my own. I would at least have a cause and potential plan instead of being here stranded on a cliff having to fight to get the time of day from doctors who just nod and give me more pills to take after the migraine starts instead of caring enough to help determine why they are starting

I’m worried I could have a dissection, had an extreme sore neck about two weeks ago could barely move my head side to side or back, but then I stretched my neck really hard to one side. Ever since I’ve been having pain on the left side of my neck and werid headaches. Should I go to the ER or am I overreacting. I have bad health anxiety

Can you have transient neck pain for months that becomes extremely painful and then goes away almost completely if this is the problem? Aspirin is the only thing that helps.

What about this but in the right artery?

I've had pain in the left side of my neck for past 8 months and I'm really worried about experiencing carotid dissection. I've been doing some yoga exercises in last couple of days but heard that yoga itself can cause carotid dissection. I just don't know what to do. I'm hopeless right now

Wanderley classes

Hi, Dr. Rybinnik, your speech pattern is like this, some of the words are not completely pronounced especially at the end of each phrase which makes it difficult to understand and it looks like you are rushing to finish the lecture as quickly as possible.