{"title":"Predisposing factors and radiological features in patients with internal carotid artery dissection or vertebral artery dissection.","authors":"Yongjun Wu, Hongbin Chen, Shihui Xing, Shuangquan Tan, Xinran Chen, Yan Tan, Jinsheng Zeng, Jian Zhang","doi":"10.1186/s12883-020-02020-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cervicocerebral artery dissection is an important cause of ischemic stroke in young and middle-aged individuals. However, very few studies have compared the differential features between internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD), including both cervical and intracranial artery dissections. We conducted a study to investigate the predisposing factors and radiological features in patients with ICAD or VAD.</p><p><strong>Methods: </strong>All cases diagnosed with cervicocerebral artery dissection, ICAD, or VAD were identified through a medical records database, between January 2010 and January 2020. Baseline characteristics, predisposing factors, and radiological features of ICAD versus VAD were compared.</p><p><strong>Results: </strong>A total of 140 patients with cervicocerebral artery dissection were included in the study, including 84 patients in the ICAD group and 56 in the VAD group. The mean age of patients in the ICAD and VAD groups was 43.37 ± 14.01 and 41.00 ± 12.98 years old, respectively. Patients with ICAD were more likely to be men compared with VAD (85.71% vs. 67.86%, p = 0.012). The frequency of hypertension, diabetes, smoking, drinking, and cervical trauma did not differ between ICAD and VAD. Dissections of ICAD were more frequently at the extracranial portions of the artery compared with those of VAD (70.24% vs. 44.64%, p = 0.003). In contrast, dissections of VAD were more common in the intracranial artery (55.36% vs. 29.76%, p = 0.003). Radiologically, double lumen (36.90% vs. 19.64%, p = 0.029) and intimal flap (11.90% vs. 1.79%, p = 0.029) were more frequently observed in ICAD than in VAD, and dissecting aneurysms were less frequent (13.10% vs. 26.79%, p = 0.041).</p><p><strong>Conclusions: </strong>The distributions of cervical and intracranial artery dissections were different between ICAD and VAD. The frequencies of radiological features detected in patients with ICAD and VAD also differed.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12883-020-02020-8","citationCount":"9","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12883-020-02020-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 9
Abstract
Background: Cervicocerebral artery dissection is an important cause of ischemic stroke in young and middle-aged individuals. However, very few studies have compared the differential features between internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD), including both cervical and intracranial artery dissections. We conducted a study to investigate the predisposing factors and radiological features in patients with ICAD or VAD.
Methods: All cases diagnosed with cervicocerebral artery dissection, ICAD, or VAD were identified through a medical records database, between January 2010 and January 2020. Baseline characteristics, predisposing factors, and radiological features of ICAD versus VAD were compared.
Results: A total of 140 patients with cervicocerebral artery dissection were included in the study, including 84 patients in the ICAD group and 56 in the VAD group. The mean age of patients in the ICAD and VAD groups was 43.37 ± 14.01 and 41.00 ± 12.98 years old, respectively. Patients with ICAD were more likely to be men compared with VAD (85.71% vs. 67.86%, p = 0.012). The frequency of hypertension, diabetes, smoking, drinking, and cervical trauma did not differ between ICAD and VAD. Dissections of ICAD were more frequently at the extracranial portions of the artery compared with those of VAD (70.24% vs. 44.64%, p = 0.003). In contrast, dissections of VAD were more common in the intracranial artery (55.36% vs. 29.76%, p = 0.003). Radiologically, double lumen (36.90% vs. 19.64%, p = 0.029) and intimal flap (11.90% vs. 1.79%, p = 0.029) were more frequently observed in ICAD than in VAD, and dissecting aneurysms were less frequent (13.10% vs. 26.79%, p = 0.041).
Conclusions: The distributions of cervical and intracranial artery dissections were different between ICAD and VAD. The frequencies of radiological features detected in patients with ICAD and VAD also differed.
背景:脑颈动脉夹层是中青年缺血性脑卒中的重要病因。然而,很少有研究比较颈内动脉夹层(ICAD)和椎动脉夹层(VAD)的区别特征,包括颈动脉和颅内动脉夹层。我们进行了一项研究,探讨ICAD或VAD患者的易感因素和影像学特征。方法:2010年1月至2020年1月期间,通过医疗记录数据库确定所有诊断为颈脑动脉夹层、ICAD或VAD的病例。比较ICAD和VAD的基线特征、易感因素和放射学特征。结果:共纳入140例脑颈动脉夹层患者,其中ICAD组84例,VAD组56例。ICAD组和VAD组患者的平均年龄分别为43.37±14.01岁和41.00±12.98岁。与VAD相比,ICAD患者以男性为主(85.71% vs. 67.86%, p = 0.012)。高血压、糖尿病、吸烟、饮酒和宫颈外伤的频率在ICAD和VAD之间没有差异。与VAD相比,ICAD在动脉颅外部分的夹层发生率更高(70.24%比44.64%,p = 0.003)。相比之下,VAD的夹层在颅内动脉中更为常见(55.36%比29.76%,p = 0.003)。影像学上,ICAD患者双腔(36.90% vs. 19.64%, p = 0.029)和内膜瓣(11.90% vs. 1.79%, p = 0.029)较VAD患者多见,夹层动脉瘤发生率较低(13.10% vs. 26.79%, p = 0.041)。结论:ICAD与VAD患者颈、颅内动脉夹层分布不同。在ICAD和VAD患者中检测到的放射学特征的频率也不同。
期刊介绍:
BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.