Differences and similarities between spontaneous dissections of the internal carotid artery and the vertebral artery

von Babo, Michelle; De Marchis, Gian Marco; Sarikaya, Hakan; Stapf, Christian; Buffon, Fréderique; Fischer, Urs; Heldner, Mirjam Rachel; Gralla, Jan; Jung, Simon; Goeggel Simonetti, Barbara; Mattle, Heinrich P.; Baumgartner, Ralf; Bousser, Marie-Germaine; Arnold, Marcel (2013). Differences and similarities between spontaneous dissections of the internal carotid artery and the vertebral artery. Stroke, 44(6), pp. 1537-1542. Baltimore, Md.: Lippincott Williams & Wilkins 10.1161/STROKEAHA.113.001057

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Background and Purpose—To compare potential risk factors, clinical symptoms, diagnostic delay, and 3-month outcome between spontaneous internal carotid artery dissection (sICAD) and spontaneous vertebral artery dissection (sVAD). Methods—We compared patients with sICAD (n=668) and sVAD (n=302) treated in 3 university hospitals. Results—Patients with sICAD were older (46.3±9.6 versus 42.0±10.2 years; P<0.001), more often men (62.7% versus 53.0%; P=0.004), and presented more frequently with tinnitus (10.9% versus 3.4%; P<0.001) and more severe ischemic strokes (median National Institutes of Health Stroke Scale, 10±7.1 versus 5±5.9; P<0.001). Patients with sVAD had more often bilateral dissections (15.2% versus 7.6%; P<0.001) and were more often smokers (36.0% versus 28.7%; P=0.007). Thunderclap headache (9.2% versus 3.6%; P=0.001) and neck pain were more common (65.8% versus 33.5%; P<0.001) in sVAD. Subarachnoid hemorrhage (6.0% versus 0.6%; P<0.001) and ischemic stroke (69.5% versus 52.2%; P<0.001) were more frequent in sVAD. After multivariate analysis, sex difference lost its significance (P=0.21), and all other variables remained significant. Time to diagnosis was similar in sICAD and sVAD and improved between 2001 and 2012 compared with the previous 10-year period (8.0±10.5 days versus 10.7±13.2 days; P=0.004). In sVAD, favorable outcome 3 months after ischemic stroke (modified Rankin Scale, 0–2: 88.8% versus 58.4%; P<0.001), recurrent transient ischemic attack (4.8% versus 1.1%; P=0.001), and recurrent ischemic stroke (2.8% versus 0.7%; P=0.02) within 3 months were more frequent. Conclusions—sICAD and sVAD patients differ in many aspects. Future studies should perform separate analyses of these 2 entities.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

De Marchis, Gian Marco; Sarikaya, Hakan; Fischer, Urs; Heldner, Mirjam Rachel; Gralla, Jan; Jung, Simon; Goeggel, Barbara; Mattle, Heinrich; Baumgartner, Ralf and Arnold, Marcel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0039-2499

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:39

Last Modified:

29 Dec 2017 10:16

Publisher DOI:

10.1161/STROKEAHA.113.001057

PubMed ID:

23632978

Web of Science ID:

000187630500567

BORIS DOI:

10.7892/boris.15728

URI:

https://boris.unibe.ch/id/eprint/15728 (FactScience: 223157)

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