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Tom's Neuro Notes

Calling All VADers

No, not Darth Vader, but LVADers and RVADers.  

 

This is an growing epidemic of “stroke” among young people, striking teenagers and 40 year old fit and trim individuals alike. 

 

One Facebook group, Vertebral Arterial Support Group has 2,200 members and is growing at the rate of nearly 30  per month.  Another group, Wallenburg or Lateral Medullary Syndrome Group, which covers one of the more painful, lasting effects of VAD currently has just over 350 members.

S

o what is VAD?  VAD stands for Vertebral Arterial Dissection.  Which means, “leading into the brain and brainstem, an Artery (not a Vein), has been (On the inside wall of the arterial) split open”.  This causes an “occlusion”, BAD thing, a stoppage of flow to the brain.

Mechanically, what happens is that the VAD occurs as an injury (TBI, Traumatic brain injury), often without the person knowing it.  A sudden twisting of the neck, and the inner lining of the artery tears away forming a pocket, behind which blood will seep through and clot.

 

 

www.vertebralarterialdissection.com

 

Sometimes attributed to side impact crashes, whiplash, Neck Adjustment, Gymnastics, Dancing and floor sports where the technique of “spotting” is used. (Spotting in gymnastics, skating and dance is when the partner or athlete maintains their head facing one direction, then turns their body as far as possible without moving their head, and finally rapidly whips their head back to original position).  Officially on medical charts, my LVAD (Left Arterial Vertebral Dissection) cause was listed as “Ballroom Dancing”.

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The first symptom that an individual often reports is serious migraine-type headaches for weeks or months, even though the individual is not prone to headaches.

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The second symptom, which can occur weeks or months afterwards, is that the torn lining gives way in the artery and a rush of lining debris, clotted blood and blood rush into the medulla and brain. This is felt as a shock of dizziness and uneasiness.

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In a fraction of a second, the individual is suffering a complete stroke, the final symptom of the VAD.

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For me, I was ballroom dancing when the stroke occurred.  I have no idea what I was doing when the original injury occurred. The good part was that my headaches finally ended.  But my long journey from victim to encouraging survivor was just beginning.  Typical of strokes was the loss of walking, speech, eye coordination, balance.  Atypical was the amount of awareness and cognitive abilities I maintained.  I was rattled, but not confused.  I lost the mental ability to add two numbers together, but not to understand the significance of numbers on a spreadsheet.

I was also surprised how quickly I progressed, but for VADers, this is also not unusual. With good physical therapy, I was walking with a cane, communicating clearly, and even able to drive within 35 days. 

All of these are normal progressions for the VADers.  Later, unfortunately, I was in the 40% that does not recover fully.   After 1 and ½ years, a series of setbacks and minor strokes reversed many of my advances, removing my ability to drive or work, and put me permanently walking with a cane.

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