Are There Differences between Traumatic and Spontaneous Cervical Artery Dissections?

Author:

Metanis Issa1ORCID,Simaan Naaem12,Schwartzmann Yoel1,Jubeh Tamer1,Honig Asaf1ORCID,Jubran Hamza1ORCID,Magadle Jad1,Cohen Jose E.3,Leker Ronen R.1ORCID

Affiliation:

1. Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel

2. Department of Neurology, Ziv Medical Center, Safed 1311001, Israel

3. Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel

Abstract

(1) Background: Cervical arterial dissections (CeAD) are a common cause of stroke in young adults. CeAD can be spontaneous (sCeAD) or traumatic (tCeAD). Whether CeAD subtypes differ in clinical, radiological, and outcome characteristics remains unexplored. (2) Methods: Patients with CeAD were identified and divided between sCeAD and tCeAD. Demographics, clinical features, risk factors, imaging findings, treatments, and outcomes were compared between the groups. Logistic regressions were used to determine characteristics associated with favorable outcome. (3) Results: Overall, 154 patients were included (106 sCeAD and 48 tCeAD). Patients with sCeAD were significantly older (mean ± SD 46 ± 12 vs. 35 ± 14, p < 0.001) and were more likely to have hyperlipidemia (19% vs. 4%, p = 0.016), but other risk factors did not differ. Patients with tCeAD less often had signs of early infarction on imaging (21% vs. 49%, p = 0.001) and had lower stroke severity on admission (NIHSS, median, interquartile range [IQR] 0 (0–9) vs. 2 (0–4), p = 0.012), but more often had symptomatic intracranial hemorrhages (12.5% vs. 2%, p = 0.006). Patients with tCeAD less often had favorable outcomes at 90 days (78% vs. 97%, p < 0.001). In the regression analysis, the only variables associated with favorable outcome were age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.03–1.24), initial stroke severity (OR 0.84, 95% CI 0.73–0.97), degree of vessel stenosis (OR 0.35, 95% CI 0.14–0.83), and involvement of multiple vessels on presentation (OR 0.04, 95% CI 0.02–0.70), whereas dissection subtype was not associated (OR 0.45, 95% CI 0.03–68.80). (4) Conclusions: Dissection subtype is not an independent modifier of the chances of attaining functional independence.

Funder

Peritz and Chantal Scheinberg Cerebrovascular Research Fund

Publisher

MDPI AG

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3