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Thread: Vertebral Artery Occlusion

  1. #1

    Vertebral Artery Occlusion

    I have a question for Dr. Young or anyone else with knowledge about vertebral artery occlusions. I provide care for a c4/c5 incomplete quad who has a left vertebral artery occlusion. She is concerned that because of this she will not be eligible for any clinical trials or treatments that may become available in the future. She has been told by many doctors that she is better off having a total occlusion than partial and therefore her concern is that if she should receive treatment that it may affect her occluded artery in a bad way.

    Is this a valid concern in anyone's opinion?

    Thanks in advance,
    Amanda

  2. #2
    Quote Originally Posted by AKBauer
    I have a question for Dr. Young or anyone else with knowledge about vertebral artery occlusions. I provide care for a c4/c5 incomplete quad who has a left vertebral artery occlusion. She is concerned that because of this she will not be eligible for any clinical trials or treatments that may become available in the future. She has been told by many doctors that she is better off having a total occlusion than partial and therefore her concern is that if she should receive treatment that it may affect her occluded artery in a bad way.

    Is this a valid concern in anyone's opinion?

    Thanks in advance,
    Amanda
    Amanda,

    What your client has is ischemic spinal cord injury. While there are currently no clinical trials that I am aware of directed at chronic spinal cord ischemia, I think that there can and will be such trials. Due to the low level of spinal cord injury research funding in the United States, there is not much diversity of spinal cord injury research. Most of the spinal cord injury models, for example, involve the lower thoracic spinal cord and mostly the acute and subacute periods. There are relatively few studies of chronic spinal cord injury and almost no studies of chronic cervical spinal cord injury due to either trauma or ischemia. Thus, there is a shortage of studies that therefore not many clinical trials.

    To increase studies of chronic spinal cord ischemia, it would be important for advocacy efforts to begin, first by finding a laboratory that is doing such research and will serve as the champion, and then raising private funds and lobbing for government funds. For example, one such laboratory is that of Martin Marsala at UCLA. He is working on ischemic spinal cord injury and a great researcher.

    In the meantime, I don't know if it help your client to know that I strongly support the above research and will do whatever I can to help. There are many people in the United States and around the world with ischemic spinal cord injury. By the way, I am moving this to the forum that discusses non-traumatic spinal cord injury.

    Wise.
    Last edited by Wise Young; 10-17-2007 at 11:02 AM.

  3. #3
    Thank you very much Dr. Young for your response and for everything you do.

  4. #4
    For my son who is thirteen months post FCE I really appreciate it. Thank you Wise.

  5. #5
    Super Moderator Sue Pendleton's Avatar
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    You can also check on the site for the Transverse Myelitis Association for research and work towards trials for incomplete non-traumatic injuries. Dr Douglas Kerr at Johns Hopkins is working with a company towards a trial that would be open to those with ischemic injuries also. Non-traumatic meaning TM, spinal strokes like your friend's not traumatic ischemia when an artery is torn violently during an auto accident or the like. Try myelitis.org and sign up. It's free.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  6. #6
    Thanks Sue, but I failed to mention that Lisa's injury is the result of a car wreck. Her doctor and the doctor's at Craig told her that the artery collapsed but was not torn, so to speak. A piece of her C4 chipped off and now C4 and C5 are fused.

    My question is, is this considered a traumatic injury?

  7. #7
    Super Moderator Sue Pendleton's Avatar
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    Quote Originally Posted by AKBauer
    Thanks Sue, but I failed to mention that Lisa's injury is the result of a car wreck. Her doctor and the doctor's at Craig told her that the artery collapsed but was not torn, so to speak. A piece of her C4 chipped off and now C4 and C5 are fused.

    My question is, is this considered a traumatic injury?
    It depends I think on what her doctors consider the foremost paralyzing injury. Were the fusions due to the chip compressing the cord or are the bone things all just that, bone problems and the long term damage is from a traumatic, large ischemic event from the accident.

    Has the artery been repaired or repaired itself?
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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