Differences and Similarities Between Spontaneous Dissections of the Internal Carotid Artery and the Vertebral Artery

There are clinical, pathologic, and outcome differences in spontaneous dissections of the internal carotid artery vs those of the vertebral artery. Spontaneous cervical artery dissection is a major cause of stroke in younger patients. Spontaneous cervical artery dissection causes up to 25% of all ischemic strokes in patients 15 to 49 years of age (Putaala J et al, Stroke 2009;40:1195-203). Although constitutional and environmental factors are both thought to play a role in spontaneous cervical artery dissection, precise causes are poorly understood. Significant differences between spontaneous internal carotid artery dissection (sICAD) and spontaneous vertebral artery dissection (sVAD) have been reported by the Cervical Artery Dissection Ischemic Stroke Patients (CADISP) group (Debette S et al, Neurology 2011;77:1174-81). The current study represents the second large analysis and comparison of sICAD and sVAD. Data were derived from 1027 patients with cervical CAD from two stroke centers in Switzerland and one in France. There were 668 patients with sICAD and 302 patients with sVAD. Patients with sICAD were older (46.3 ± 9.6 years vs 42.0 ± 10.2 years; P < .001), more often men (62.7% vs 53.0%; P = .004). Patients with sICAD were also more likely to present with tinnitus (10.9% vs 3.4%; P < .001) and to have more severe ischemic strokes (median National Institutes of Health Stroke Scale: 10 ± 7.1 vs 5 ± 5.9; P < .001). There were more bilateral dissections among those wi...
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Abstracts Source Type: research