Traumatic
Traumatic vertebral dissection may follow blunt trauma to the neck, such as in a traffic collision, direct blow to the neck, strangulation, or whiplash injury. 1–2% of those with major trauma may have an injury to the carotid or vertebral arteries. In many cases of vertebral dissection, people report recent very mild trauma to the neck or sudden neck movements, e.g. in the context of playing sports. Others report a recent infection, particularly respiratory tract infections associated with coughing. Trauma has been reported to have occurred within a month of dissection in 40% with nearly 90% of the traumas being minor. It has been difficult to prove the association of vertebral artery dissection with mild trauma and infections statistically. It is likely that many "spontaneous" cases may in fact have been caused by such relatively minor insults in someone predisposed by other structural problems to the vessels. A more likely theory, also as yet unproven, is that the low-energy traumatic dissections are actually spontaneous dissections brought to medical attention by the onset of neurological symptoms. These neurological events represent embolic phenomena due to loosening or breakdown of the clot at the site of the dissection, which can be triggered by low energy trauma or even occur spontaneously. The fragments travel within the arterial system downstream to the brain to cause stroke or stroke-like symptoms. Vertebral artery dissection has also been reported in association with some forms of neck manipulation. There is significant controversy about the level of risk of stroke from neck manipulation.
Peginterferon beta-1a, sold under the brand name Plegridy, is medication used to treat multiple sclerosis. The most common side effects include headache, muscle pain, joint pain, influenza (flu)-like symptoms, pyrexia (fever), chills, asthenia (weakness), and erythema (reddening of the skin), pain or pruritus (itching) at the injection site.Peginterferon beta-1a was approved for medical use in the United States and in the European Union in 2014. Medical uses
In the United States peginterferon beta-1a is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.In the European Union peginterferon beta-1a is indicated for the treatment of relapsing remitting multiple sclerosis in adults. References
External links
"Peginterferon beta-1a". Drug Information Portal. U.S. National Library of Medicine. Plegridy at the US National Library of Medicine Medical Subject Headings (MeSH)