Having had the misfortune to suffer and endure a Brain Stem Stroke caused by the Dissection of the Right Vertebral artery, with three weeks in Royal Prince Alfred Hospital, Sydney followed by two weeks in Rehab at Alwyn Hospital, Sydney I felt lost and all alone back at home.
Family and friends tried their best to keep me fed and amused as best as they could but something was badly lacking. I wanted to find out all about my stroke and how to fight it and was desperate to find at least one person on earth who survived a similar stroke I could communicate with.
In Year 2000 there were a handful of search engines like Alta Vista, Copernickus, Yahoo and Google. Even internet was in its infancy and all I had was a slow Windows XT Computer at home.
The best thing that ever happened to me was to find the Harvard Neurology Forum for stroke survivors and carers.
On May 24th 2001, I created a Yahoo group called VAD Club and even today in 2014 there are 36 members. Initially it was meant only for VAD but as time passed many who had suffered from Carotid Artery Dissections wanted to be members. So the VAD Club became a VAD - CAD CLUB.
Family and friends tried their best to keep me fed and amused as best as they could but something was badly lacking. I wanted to find out all about my stroke and how to fight it and was desperate to find at least one person on earth who survived a similar stroke I could communicate with.
In Year 2000 there were a handful of search engines like Alta Vista, Copernickus, Yahoo and Google. Even internet was in its infancy and all I had was a slow Windows XT Computer at home.
The best thing that ever happened to me was to find the Harvard Neurology Forum for stroke survivors and carers.
Harvard Neurology Forum
Have you already seen this from the Harvard Neurology Forum?
( Note this Forum was closed down a few years later leaving all forum members in the lurch. We tried to regroup but it was never the same.)
18th Feb 2002
Jill
This article as submitted by sheila was what got me started with the VAD web site as well as VAD group. John Cervaks and Andrea were also located after reading this article. Unfortunately could never locate Sheila. would be nice if we can trace her.
I can see that you are doing searches on the net. Thanks for the support.
ram
VAD CLUB
On May 24th 2001, I created a Yahoo group called VAD Club and even today in 2014 there are 36 members. Initially it was meant only for VAD but as time passed many who had suffered from Carotid Artery Dissections wanted to be members. So the VAD Club became a VAD - CAD CLUB.
Group Description
This is an exclusive club for people who have suffered a "Stroke" from the dissection of a Vertebral or Carotid arteries in the neck.
Group Email Addresses
- Post Message :
vad-club@yahoogroups.com - Subscribe :
vad-club-subscribe@yahoogroups.com
Friends, you and me ....
You brought another friend ....
And then there were 3 ....
We started our group ....
Our circle of friends ....
There is no beginning or end
I had to post this, it was too tempting.
Though we have only a few members ( I anticipated this as surviving VAD is very uncommon ) lot more visitors and members from around the world will join when the website is a bit more professional and we host it on the web.
Ram
24/05.2001
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Ram
24/05.2001
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16th Feb 2002
As an engineering student I always found it easy to find a simple analogy to explain a complex phenomenon so that the idea never fades from the mind. For us non doctors all medical terms are mumbo jumbo, and doctors thrive on this as we are considered less smart to understand what they have to say. For example GP's commonly say well you have an infection or a virus, when they do not really know what the diagnosis is. The same with neurologists, if they do not have an answer, they will call it a migraine and push some medication without much consideration for the side effects these can have on the poor patient.
Two weeks before my stroke my neurologist after a CT-scan and doppler (which are mere formalities as ct scans show not much) treated me for migraine with sando migran $200. This reduced the flow in my arteries to the brain and sent me reeling and whole body burning all the time. Another visit and another $150, he changed the medicine to Tofranil another migraine medication.
Without getting emotional and side tracked, I was going to explain the simple plumbimg of the blood to the brain. here I go.
the heart- SPA pump
Consider the heart as a water pump in a SPA which we will assume is encased. The reason I say SPA is that it recirculates the water.
There is one main pipe called the aorta that pumps blood out of the heart. This then divides into two and sends blood up to the brain and down to the rest of the body. The one that goes up to the neck is called the subclavian artery which branches into the right and left carotid arteries and left and right vertebral arteries. The carotid arteries run in the neck in front, are large and carry a lot of blood to the brain (garden in general, say the lawn) while the vertebral arteries are much smaller tubes carrying much less blood. They however supply blood to a very important part of the brain (may be your favourite flower bed without which your garden may look dead) called the brain stem that controls a number of very important functions like breathing & swallowing and many others . The two vertebral arteries go up the brain very well protected by rings in the cervical vertebrae and join up to form the basillar artery.
Now the vertebral, carotid and the basillar arteries are like flexible garden hoses. They do not leak . You can get the water to where you want in the garden but you cannot just pore it. You want to properly distribute the water to the region.(like using a sprinkler) In the case of arteries we have much smaller set of arteries like tree roots, which are porous allowing the blood to ooze out from them into the brain. You have the PICA (Posterior inferior cerebelar artery that branches out from each vertebral before they join to form the basilar. In a similar fashion we have the left and right AICA- anterior inferior cerebellar artery that branch out from the basillar artery. Both the PICA and AICA are responsible for life. If PICA is blocked on one side we have may be paralysis on one side. if both sides are affected then may be we get hit both sides. If the aica gets blocked, then only God can save us.(We may suffer what is called a Locked in syndrome-alive but brain dead) When these porous pipes face excess pressure as in high blood pressure, instead of the blood oozing into the brain there is a bleed called haemorraging which could damage brain cells around the area causing a sroke.
Now we have forgotten about the carotid arteries that carry more blood than the vertebrals to the brain. each carotid splits into internal and external carotid arteries supplying the outer parts of the skull and the inside of the main brain which can be compared to your hard disk that stores all your information and files.
The brain stem supplied by PICA and AICA is sort of similar to the RAM (random access memory) of a computer.
The basillar goes up and joins the Circle of willis or the cerebral arterial circle, by joining up with branches from internal carotid artery, potentially providing an alternative source of blood to the brain if any of these arteries is blocked.
Basially what it means is that it is a fail proof system that will work just as efficiently even if one artery is blocked. In my case the right vertebral artery is totally blocked in the neck. If I had been left untreated for any length of time the residual blood in my pica would have turned into a permanent clot causing permanent damage. All of us are lucky to be around mostly because of heparin drips that thins the blood making it easier to get to the brain through the longer route of going up the carotids and down the basillar in the worst case scenario. When not enough blood is oozing out of these perforated arteries it is called Hypo perfusion of the artery-simply meaning not enough blood is coming to this section of the brain from this artery.
I compared the heart to the SPA as it recirculates the blood. The blood is ofcourse oxygenated in the lungs and revitalised by absorbing energy from the digestive system and then filtered in the kidneys to get rid of excess water before being pumped back to the brain and the rest of the body.
If you can follow this then a dissected artery is simply a kinked artery or a stretched artery as in kinked or flattened garden hoses that will not allow flow.
Another important aspect of the artery is to understand that it has an outer and an inner wall. If you run your car over the garden hose what happens, a crack develops on the inner wall along the length of the pipe. When this happens if the fluid pressure is high, then the fluid starts to flow between the two walls of the artery as far as it can go and then starts to bulge out blocking the main and original flow. This is a true dissection that most of us have suffered. It is very unlikely that these heal.
For those whose arteries have healed afer the stroke it is more likely a blood clot that moved up from the heart and blocked the artery temporarily and got dissolved with time and medication. This is called an oclusion caused by blood clots. Most neurologists use the word dissection losely. Majority of the carotid artery strokes is due to occlusion.
Now you can understand why Hero's in movies turn the heads of the baddies. By turning the neck beyond the limit, the very vertebrae that are there to protect the artery act like a shear cutting the artery leading to death. of course the spinal cord is also wrecked.
If only God had designed our necks to turn 360 degrees a we see in the Exorsist there may not be anything called VAD. May be the devil is a better designer ?????
Trust this helps.
It is 11.30pm. I am alone at home & starving and do not feel like cooking either. May be settle for some ice cream (sugar free) and some fruits.
RamboAus
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16th Feb 2002
Understanding arteries supplying blood to the brain:
Understanding arteries supplying blood to the brain:
To explain a few things the left and the right vertebral arteries travel up the neck on either side of the cervical spine as you know and then go under the skull and turn left & right to get to the middle brain stem where the two meet up and then proceed vertically upwards in an artery called the basilar artery. The basilar goes further up and joins what is called the circle of willis which is also joined by the carotids. So God has designed a fool proof system, where one section is blocked off, blood flow can be restored from another artery. It is all fluid dynamics and pipe flow as we studied in engineering.
One of the reason that I am surviving or got over the stroke is due to the fact that blood is going up my left vertebral where it meets the basilar and also flows down ward the section of the right vertebral that is not blocked and into the PICA.
This is the good part of it.
The bad part is that before the vertebrals meet the basillar arterry they have the PICA (Posterior inferior cerebellar artery ) which is coser to the neck. These left & right PICA are critical arteries as blood perfuses (Oozes) out of the artery into the brain. It feeds the brain stem with Oxygen. The vertebral and the basillar are like solid pipes while the AICA and the PICA are like garden hoses with holes in them for trickling water to the plants. The AICA is even more important and comes off on either side from the Basilar artery before it joins the circle of willis.
The AICA and PICA are very critical as they supply the main brain stem. Any flow problem to these is bad news. That is why the vertebrals are so well protected inside rings in the cervical vertebrae.
In my case, I have been told that I do not have a right PICA and that I have a very dominant AICA, which is still getting adequate blood supply and hence my survival. If the PICA existed and was without blood supply, I would have suffered irreversible damage like permanent paralysis. Further the fact that it has taken about ten years to occlude the body has developed a strong collateral blood supply to the area supplied by the Pica from the damaged artery.
So what is paramount is to ensure with or without surgery that the flow to the PICA and the AICA is not impaired.
I am writing all this to give you a better understanding of the arterial system in the brain.
Neuros are still coming to grips with the vertebral artery. Before the advent of MRI, MRA and Trans cranial dopplers, xray and CT scans did not say much and stroke from vertebral artery dissection was not understood.
With all my research, I am beginning to find that a lot of issues in the head like Sinus, migraine head aches, tinnitus and eye problems like double vision etc are related to blood supply in the vertebrals. They had no means to establish this earlier. Thanks to engineering technology and electronics we can work wonders these days. The only sad thing is that there are so many neuros (old timers) who do not keep pace with the progress.
Timothy Liem, a vascular neuro surgeon belongs to the aggressive younger generation, who must have played a lot of video games to understand computers and medical equipment.
Ram.
RamboAus
PS: this is an extract of what i wrote to Jill last year. I will try and rewrite the plumbing theory again to understand blood supply and blood perfusion etc.
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16th Feb 2002
To all new members this is perhaps the most informative article on VAD. I have a link for this on the web site. if you have not seen it, here it is again. It will perhaps answer most of your questions if not all. It also tell you what symptoms are VAD-stroke related.
RamboAus
