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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Medical
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Experience:  17 yrs experience in treating OPD & Emergency patients.
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Suffered a bi-lateral vertebral dissection 10 days ago. The

Resolved Question:

Suffered a bi-lateral vertebral dissection 10 days ago. The dissections were outside of the cranium..around the c1/c2 vertebrae. I was given iv drip heparin for three days and released. I am taking baby aspirin daily for three months. Does this treatment regiment sound sufficient?

Submitted: 1 year ago.
Category: Medical
Expert:  Dr. P. Jyoti replied 1 year ago.
Hello,

Yes, this is the standard treatment for vertebral artery dissection.

Treatment is with anticoagulants such as heparin and warfarin or antiplatelets like aspirin.

Both are considered equally efficacious as of now and it is really the doctors choice.

Two points to discuss with your doctor are:
Whether anticoagulant like Warfarin might be better than aspirin
Whether treatment should be for 6 months.

This will help you get an informed discussion.

But in general your treatment plan is according to protocol for this condition.


Hope this shows you the way forward - wish you good health and a quick recovery.

I hope my answer has helped you gain more knowledge and confidence about your problem and in knowing what to discuss with your doctor.

I hope my answer has satisfied you. Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Bonus is always welcome - Thank you!

Dr.P.Jyoti, MD.
Customer: replied 1 year ago.

Thank you. I am just looking for other qualified opinions on the anticoagulant vs antiplatelet therapies. My doctor is a stroke specialist at Beth Israel in NYC which is also an academic hospital...hence I was putting faith in her expertise but obviously still question what is best. She told me that recent studies had shown no real benefit to to warfarin vs. aspirin and that warfarin had more possible complications. Therefore she chose aspirin for at least three months until my follow up scans.


 


Opinion?


 


Thank you.

Expert:  Dr. P. Jyoti replied 1 year ago.
Yes thats right, she is quite right.

There are as yet no data from large scale studies which show which is more beneficial. Any difference is sure to be a small one even if there is any difference. On the other hand it is known that anticoagulants can have side effects.

That is why in the US most doctors prefer the antiplatelet route. But in some countries like the UK, doctors go for either choice depending on their personal choice.

So both choices are scientifically valid, and anticoagulants have the slight disadvantage of greater side effects.

So I would agree basically with your doctor. That is my honest opinion.


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Dr. P. Jyoti, Consultant MD
Category: Medical
Satisfied Customers: 8947
Experience: 17 yrs experience in treating OPD & Emergency patients.
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