Anyone suffer a VAD-Vertebral Artery Dissection with Stroke?

[Jesse Jaymes]

Super odd and random question. But I am seeking out some consult (not really advice). Anyone suffer a Dissection? I had one Wednesday night. Beyond grateful my wife is a Physician's Assistant and knows me better than I know myself. Simply eating dinner together and got nauseous. Immediately followed by vertigo. I was testing myself. I couldn't walk straight. Scalp on right side got very "tight". Pin point headaches in two spots. One the back of the neck (actual site of dissection) and the other straight on the top of my head. I NEVER get headaches.

She opted (correctly) to run me in. Passed most of the neurological tests. But poor balance. Which led to going to the bigger hospital. CT and MRI came back positive. Dissection and stroke.

Believe my wife literally saved my life. My blood pressure was 180/110. Not good for microscopic leaks of blood in your artery to your brain. I seem to have suffered minimal damage. It's Sunday. I just walked the dogs over a mile. Third day I've done this. Can balance on both feet, etc. If it was simply a dream....I'd never know.

I got shit for discharge instructions other than "take it easy a while" and no lifting over 10 pounds.

My seeking out someone who's survived similar....I am an extreme OverThinker. I've been told by the best neurosurgeon in town...the artery will heal. From inside out. 2-3 weeks of rest. Then ease into things.

But every time I bend over to put on shoes......"Will this kill me"? I am already struggling with "What's Too Much" look like? I don't think there's a warning for the next one. I don't think you "Feel" an artery stress. I didn't.

I had an other post about low back issues recently. I'm 52. Pretty fit. Shot and packed a buck off the mountain solo. One trip. Wasn't brutal. Was uncomfortable at times. I just pushed my way through it. I recall that the weight on my shoulders was more like 90% vs on my hips. I was gonna shuck the pack up higher on my back and re-tighten waist belt. But having a full load...I didn't want parts to slip out of the pack. Just gutted it out.

If that's what caused it (Ive heard that these dissections can kinda linger a bit then finally break)......how much can I pack in the future? Half a buck? Never pack again?

Maybe I am over complicating things and over thinking.....but would this bother anyone else? Being a Pussy?

 

[PNWGATOR]

Damn. I’m glad you’re okay. That’s a big deal. Glad you went in and were evaluated and got the news you did.

Trust the neurosurgeon who treated and diagnosed your specific case. If you have questions or need clarification, reach out to your neurosurgeon and follow up with them. All individuals and their circumstances are different and my advise is to trust your physician/specialist and if you still have questions get clarification from them or seek a second opinion.

That said, I have a co worker who suffered a dissection of a carotid artery secondary to a chiropractic adjustment. Evaluated by several specialists and rested for many weeks and now back to full duty with no restrictions.

 

[Jesse Jaymes]

Copy. I've not researched the difference between the two, but have read they're similar. Do have follow ups. I've reached out to an ED Dr that is a buddy...and hunter as well and is much more Dude than Dr. Just hoping for someone who can both provide professional insight, but have some "bearing". Although I am finding myself in an office setting, that's not my full "day job". You know what I do.

I want some honest feedback for the future. As I said....discharge did a SHIT job. "Take it easy" doesn't really frame parameters.

I know your profession too. So thanks for the insight

 

[willtim]

You should be seen by a vascular surgeon.

 

[Jesse Jaymes]

For consult or follow up? Been told by everyone this is non Op

 

[ramsdude47]

Go talk to your PCP about it. Read your discharge summary if you haven’t. Not the paperwork the nurse hands you, the note put in by the attending doctor that signed your discharge order.

I’m surprised there was no clear precipitating event. There has been for every case I have seen in my ~5 year stint on a Neuro floor. Several chiropractor visits gone bad, but otherwise traumas (car accidents usually). My dentist told me she had one many years back (MTB crash) and has had no problems since. You will probably be on Eliquis for life. I don’t think your ability to pack our animals will be impacted, but you will need to be very careful not to fall.

 

[Marbles]

As @PNWGATOR said, fall back on the provider team that is already treating you.

Keeping things very general. There is no known preventative measures to keep it from happening again. General vascular health cannot hurt though. If you have high BP, see a provider and get it treated. If you use tobacco, stop. Talk to your provider about cholesterol and consider the lower targets of European guidelines.

Beyond that, relax, outcomes are usually very good, and it sounds like yours will be too.

 

[yfarm]

Not aware there is any surgical treatment for a vertebral dissection, stroke neurologist would be my choice for a second opinion if thats what you are seeking. Most cases I’ve seen are from car accidents or chiropractors as previously noted. Wife has a friend who had a spontaneous dissection as was yours apparently, she is 15 yrs out and has done fine.

 

[Jesse Jaymes]

Appreciate the feedback.

My wife was thrilled at the rest of my labs, tests and images. Brain looks amazing. EKG and Echo are almost Lance Armstrong like (jokes...but stellar reports). No tobacco.

I get I let my BP "slip". Been creeping up. Was on meds. I stopped them. Got BP naturally into the 130/90 range. Put back on a few pounds. And had too much Summer fun of good food and beers.

Cholesterol has been borderline High for some time.

Be kinda off topic. But.....I am on TRT. My HRT Dr seems to be cutting edge on many of these things. Much more like Hubberman than a Steroid salesman. Has many many new studies of the positive and benefits of it. He also really breaks down Cholesterol. We've spent literally hours....myself, my wife comes with me, and him....going over Statins, Cholesterol, ratios. What the true meaning of the entire panel represent. He's very anti statin.

Throws down a challenge of (what's the plaque scan of all of your arteries??). Spend the $150 out of pocket and get your scan. See how clogged or unclogged your plumbing is.

Scared straight now to make even more changes.

 

[Jesse Jaymes]

RE: Precipitating event. I wish I could pin point it. I packed that whole buck out on Sunday. Most of the weight was on my shoulders, not my hips. I had one slip down to my knees as I hit a spot where the sun melted the previously frozen dirt of a burned slash pile. Just down to one knee with a 100lb pack. Recall nothing of my neck. No pain. Doubt the pack even touched my neck. Traps for sure. But no neck.

Day of VAD. Trained arms. Did "Prison Dips" at 3:30pm. Very deep. Deeper than usual. Was trying to touch my chin to cross bar. But just body weight. Did lots of them. Felt good. Maybe 6 sets of 15ish. By 6:30 I had my symptoms and dissected.

Only things I can think remotely close. I don't grapple. No training. No sparring. Nada.

 

[willtim]

There is no surgical treatment for a vertebral artery dissection. A neurologist and/or a neurosurgeon are not trained in managing blood vessels. They occur spontaneously and are more common in young women. Watch your BP.

 

[Wrench]

Glad that went well!

I'm impressed by the responses as well. Pretty amazing company kept here.

 

[KG406]

I also had a vertebral artery dissection in late June that resulted in a stroke... was otherwise perfectly healthy and only 33 years old! Took over a week between the hospital and rehab before I could even walk again with a cane and finally got to go home. And then all summer of taking it easy besides PT and balance exercises.

It's now been a little over 4 months and my vision is back to nearly 100% and my balance/agility is probably 80%. Day-to-day life I hardly even notice, but in the mountains with uneven and slippery footing I am definitely reminded that I am no longer what I once was. Hiking in the dark without a headlamp also kicks my ass. My neurologist expects to keep seeing improvement for up to a year so I am hopeful!

Almost 2 weeks prior to the stroke I got a horrible headache that never went away... I should have gone into the doctor because I also never get headaches. They believe that was when the dissection actually occurred. The exact cause is unknown, but a few weeks prior to the headache I hit hard after getting bucked off a horse. They believe that could have been the final straw after many years of hard hits from horses, bulls, skiing, biking, etc.

My follow up MRAs show the dissection healed great, and there were no other areas of concern. They said I can pretty much go back to living life as normal, but they did suggest I should try to take it easy with hard hits and slow down a little, regardless of the dissection haha. They were not concerned at all with things like strenuous pack outs

 

[KG406]

I forgot to mention, the headache started while working out. Nothing crazy, but with every minute outside of my job spent building our house I hadn't worked out in months and was easing back into mtn tough

 

[SloppyJ]

Crazy stuff! Glad you're feeling better. My mom had 3 brain surgeries over her life and I was there for the last one. I learned a lot about doctors during that time. Some are great and honestly care, others, well I don't get that vibe. It's a shame to see what our Healthcare system has become.

I'd go to a specialist that dealt more in the vascular system rather than neurology. This seems to be a vascular issue that presented itself in the brain.

Keep that BP in check!

 

[Jesse Jaymes]

I also had a vertebral artery dissection in late June that resulted in a stroke... was otherwise perfectly healthy and only 33 years old! Took over a week between the hospital and rehab before I could even walk again with a cane and finally got to go home. And then all summer of taking it easy besides PT and balance exercises.

It's now been a little over 4 months and my vision is back to nearly 100% and my balance/agility is probably 80%. Day-to-day life I hardly even notice, but in the mountains with uneven and slippery footing I am definitely reminded that I am no longer what I once was. Hiking in the dark without a headlamp also kicks my ass. My neurologist expects to keep seeing improvement for up to a year so I am hopeful!

Almost 2 weeks prior to the stroke I got a horrible headache that never went away... I should have gone into the doctor because I also never get headaches. They believe that was when the dissection actually occurred. The exact cause is unknown, but a few weeks prior to the headache I hit hard after getting bucked off a horse. They believe that could have been the final straw after many years of hard hits from horses, bulls, skiing, biking, etc.

My follow up MRAs show the dissection healed great, and there were no other areas of concern. They said I can pretty much go back to living life as normal, but they did suggest I should try to take it easy with hard hits and slow down a little, regardless of the dissection haha. They were not concerned at all with things like strenuous pack outs

KG-

This is exactly the shit I was trolling for. Someone with similar situation...a bit further ahead of me...with a Win! Your post means the World to me

 

[Forestryguy]

Just went over TAA & AAA in classes this past few weeks for nursing school. So what I say is more than likely just textbook talk and may not be 100% correct. I would watch your BP, that is a major cause for ruptures in TAA & AAA, not sure how it would be any different with a VAD. Control of cholesterol, and pretty much every other issue, should be attempted tp correct without meds if possible. There are so many side effects and contraindications for use.

When I get a chance I'll look more into VADs. But I would be interested to hear why they say it will heal itself and hoe they really differ from TAA & AAA/dissections.

Glad you are doing well.

 

[willtim]

If you smoke...stop.

 

[Jmort1754]

Blood pressure control

Don't rush back into things take it slow let it heal. This time of year sucks for it but if you continue to take care of yourself you'll have next year.

 

[KG406]

Jesse - as the others have said BP is the biggest thing I've been told to keep a close eye on. mine was never concerningly high, but was not great either. My wife is a nurse and is very adamant about watching blood pressure. For me work/stress was the biggest contributor to my higher BP, since the stroke I've been much better about leaving work at work and not letting it control my life.

My cholesterol is good, but they had me on a statin for a couple months just as a precaution. However I will be on a low dose aspirin for the foreseeable future