A Comparative Study of the Etiology of Intracranial Vertebral Artery Dissection and Carotid Artery Dissection.
Journal
The neurologist
ISSN: 2331-2637
Titre abrégé: Neurologist
Pays: United States
ID NLM: 9503763
Informations de publication
Date de publication:
01 Sep 2023
01 Sep 2023
Historique:
medline:
26
9
2023
pubmed:
31
1
2023
entrez:
30
1
2023
Statut:
epublish
Résumé
Both extrinsic (trauma or violent movement) and intrinsic (structural abnormality, atherosclerosis, or hemodynamic instability) factors may result in arterial dissection. The role of these factors in the origin or progression of dissection remains unclear. This study aimed to characterize the clinical features, radiologic features, and outcomes of intracranial vertebral artery dissection compared with carotid artery dissection and to determine the major causative factors. Consecutive patients with craniocervical dissection (n=127) were retrospectively analyzed. Patients with intracranial vertebral artery dissection (n=77) and those with carotid artery dissection (n=35) were compared with respect to patient age, sex, cerebrovascular risk factors, laboratory indices, and radiologic features. Intracranial vertebral artery dissection was the most common craniocervical arterial dissection in our cohort (n=77, 60.6%). Body mass index in the intracranial vertebral artery dissection group was significantly greater than that in carotid artery dissection group. Clinical manifestations of intracranial vertebral artery dissection included ischemic stroke (37.7%), dizziness or vertigo (39.0%), and headache or neck pain (44.2%). Two patients had a definite history of trauma. The frontal and lateral tortuosity ratios of the vertebral basilar artery were significantly greater while the vertex angle was smaller in the intracranial vertebral artery dissection group compared with carotid artery dissection group. A positive correlation between the tortuosity ratios and subarachnoid hemorrhage and a significant inverse correlation between the tortuosity ratios and lipid parameters (high-density lipoprotein; apolipoprotein A1) were identified. Intrinsic causes may play a more important role in the development of intracranial vertebral artery dissection than carotid artery dissection.
Sections du résumé
BACKGROUND
BACKGROUND
Both extrinsic (trauma or violent movement) and intrinsic (structural abnormality, atherosclerosis, or hemodynamic instability) factors may result in arterial dissection. The role of these factors in the origin or progression of dissection remains unclear. This study aimed to characterize the clinical features, radiologic features, and outcomes of intracranial vertebral artery dissection compared with carotid artery dissection and to determine the major causative factors.
METHODS
METHODS
Consecutive patients with craniocervical dissection (n=127) were retrospectively analyzed. Patients with intracranial vertebral artery dissection (n=77) and those with carotid artery dissection (n=35) were compared with respect to patient age, sex, cerebrovascular risk factors, laboratory indices, and radiologic features.
RESULTS
RESULTS
Intracranial vertebral artery dissection was the most common craniocervical arterial dissection in our cohort (n=77, 60.6%). Body mass index in the intracranial vertebral artery dissection group was significantly greater than that in carotid artery dissection group. Clinical manifestations of intracranial vertebral artery dissection included ischemic stroke (37.7%), dizziness or vertigo (39.0%), and headache or neck pain (44.2%). Two patients had a definite history of trauma. The frontal and lateral tortuosity ratios of the vertebral basilar artery were significantly greater while the vertex angle was smaller in the intracranial vertebral artery dissection group compared with carotid artery dissection group. A positive correlation between the tortuosity ratios and subarachnoid hemorrhage and a significant inverse correlation between the tortuosity ratios and lipid parameters (high-density lipoprotein; apolipoprotein A1) were identified.
CONCLUSIONS
CONCLUSIONS
Intrinsic causes may play a more important role in the development of intracranial vertebral artery dissection than carotid artery dissection.
Identifiants
pubmed: 36715669
doi: 10.1097/NRL.0000000000000484
pii: 00127893-990000000-00055
pmc: PMC10521784
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
281-286Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Cerebrovasc Dis. 2007;23(4):275-81
pubmed: 17192705
Kyobu Geka. 2013 Jun;66(6):437-44
pubmed: 23917045
Cerebrovasc Dis. 2013;35(2):175-81
pubmed: 23429170
J Neurol Neurosurg Psychiatry. 2009 Feb;80(2):232-4
pubmed: 19151021
Stroke. 2014 Jan;45(1):37-41
pubmed: 24326451
Ann Vasc Surg. 2013 May;27(4):497.e15-21
pubmed: 23548267
Stroke. 2009 Apr;40(4):1195-203
pubmed: 19246709
Stroke. 2013 Jun;44(6):1537-42
pubmed: 23632978
Insights Imaging. 2013 Feb;4(1):135-42
pubmed: 23203816
J Clin Neurosci. 2019 Oct;68:28-32
pubmed: 31399319
AJNR Am J Neuroradiol. 2014 Feb;35(2):323-6
pubmed: 24184518
Clin Neurol Neurosurg. 2020 Oct;197:106184
pubmed: 32916394
J Vasc Surg. 1993 Jul;18(1):95-9
pubmed: 8326665
Curr Pain Headache Rep. 2019 Jan 19;23(1):2
pubmed: 30661121
World Neurosurg. 2018 Dec;120:e1185-e1192
pubmed: 30236811
Acta Neuropathol Commun. 2013 Oct 28;1:71
pubmed: 24252658
Cephalalgia. 2008 Jun;28(6):671-3
pubmed: 18384414
J Biomech. 2008 Aug 7;41(11):2498-505
pubmed: 18573497
Can J Cardiol. 2010 Apr;26(4):137-9
pubmed: 20386774
Man Ther. 2011 Aug;16(4):351-6
pubmed: 21256072
N Engl J Med. 2011 Jan 13;364(2):127-35
pubmed: 21226578
Neurol Sci. 2014 Feb;35(2):331-2
pubmed: 24068483
Curr Opin Neurol. 2014 Feb;27(1):20-8
pubmed: 24300790
World Neurosurg. 2019 Jun;126:e402-e409
pubmed: 30822585
Neurology. 2011 May 17;76(20):1735-41
pubmed: 21576691
Emerg Med (Fremantle). 2002 Dec;14(4):412-21
pubmed: 12534485
Curr Pain Headache Rep. 2016 Dec;20(12):68
pubmed: 27873124
JAMA. 1999 Dec 1;282(21):2035-42
pubmed: 10591386
Headache. 2008 Apr;48(4):621-4
pubmed: 18377386
Stroke. 2016 Oct;47(10):2548-52
pubmed: 27531344
Stroke. 2013 Jan;44(1):126-31
pubmed: 23204054
Clin J Sport Med. 2014 Mar;24(2):155-7
pubmed: 24056473
Neurosurgery. 2017 Mar 1;80(3):368-379
pubmed: 28362967
J Neuropathol Exp Neurol. 2014 Oct;73(10):916-32
pubmed: 25192048