Differential features of carotid and vertebral artery dissections The CADISP Study

被引：169

作者：

Debette, S. ^{[1
,2
,3
]}

Grond-Ginsbach, C. ^{[4
]}

Bodenant, M. ^{[1
]}

Kloss, M. ^{[4
]}

Engelter, S. ^{[5
]}

Metso, T. ^{[6
]}

Pezzini, A. ^{[7
]}

Brandt, T. ^{[8
]}

Caso, V. ^{[9
]}

Touze, E. ^{[10
]}

Metso, A. ^{[6
]}

Canaple, S. ^{[11
]}

Abboud, S. ^{[12
]}

Giacalone, G. ^{[13
]}

Lyrer, P. ^{[5
]}

del Zotto, E. ^{[7
]}

Giroud, M. ^{[14
]}

Samson, Y. ^{[15
]}

Dallongeville, J. ^{[2
]}

Tatlisumak, T. ^{[6
]}

Leys, D. ^{[1
]}

Martin, J. J. ^{[16
]}

机构：

[1] Lille Univ Hosp, Dept Neurol, EA1046, Lille, France

[2] Inst Pasteur, INSERM, Dept Epidemiol & Publ Hlth, U744, F-59019 Lille, France

[3] Univ Versailles St Quentin Yvelines, Raymond Poincare Hosp, Dept Epidemiol & Publ Hlth, Garches, France

[4] Univ Heidelberg Hosp, Dept Neurol, Heidelberg, Germany

[5] Univ Basel Hosp, Dept Neurol, CH-4031 Basel, Switzerland

[6] Univ Helsinki, Cent Hosp, Dept Neurol, Helsinki, Finland

[7] Brescia Univ Hosp, Neurol Clin, Dept Med & Surg Sci, Brescia, Italy

[8] Schmieder Klin, Dept Rehabil, Heidelberg, Germany

[9] Univ Hosp Perugia, Stroke Unit, Perugia, Italy

[10] Paris Descartes Univ, St Anne Hosp, Dept Neurol, INSERM,UMR S894, F-75674 Paris, France

[11] Univ Hosp Amiens, Dept Neurol, Amiens, France

[12] ULB, Lab Expt Neurol, Brussels, Belgium

[13] Milan San Raffaele Univ Hosp, Dept Neurol, Milan, Italy

[14] Univ Hosp Dijon, Dept Neurol, Dijon, France

[15] Pitie Salpetriere Univ Hosp, Dept Neurol, Paris, France

[16] Sanatorio Allende, Dept Neurol, Cordoba, Argentina

来源：

NEUROLOGY | 2011年 / 77卷 / 12期

基金：

芬兰科学院;

关键词：

VASCULAR RISK-FACTORS; ISCHEMIC-STROKE; CEREBROVASCULAR ISCHEMIA; YOUNG-ADULTS; INFECTION; ASSOCIATION; ENDOTOXIN; MIGRAINE; ANEURYSM; CELLS;

D O I：

10.1212/WNL.0b013e31822f03fc

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To examine whether risk factor profile, baseline features, and outcome of cervical artery dissection (CEAD) differ according to the dissection site. Methods: We analyzed 982 consecutive patients with CEAD included in the Cervical Artery Dissection and Ischemic Stroke Patients observational study (n = 619 with internal carotid artery dissection [ICAD], n = 327 with vertebral artery dissection [VAD], n = 36 with ICAD and VAD). Results: Patients with ICAD were older (p < 0.0001), more often men (p = 0.006), more frequently had a recent infection (odds ratio [OR] = 1.59 [95% confidence interval (CI) 1.09-2.31]), and tended to report less often a minor neck trauma in the previous month (OR = 0.75 [0.56-1.007]) compared to patients with VAD. Clinically, patients with ICAD more often presented with headache at admission (OR = 1.36 [1.01-1.84]) but less frequently complained of cervical pain (OR = 0.36 [0.27-0.48]) or had cerebral ischemia (OR = 0.32 [0.21-0.49]) than patients with VAD. Among patients with CEAD who sustained an ischemic stroke, the NIH Stroke Scale (NIHSS) score at admission was higher in patients with ICAD than patients with VAD(OR = 1.17 [1.12-1.22]). Aneurysmal dilatation was more common (OR = 1.80 [1.13-2.87]) and bilateral dissection less frequent (OR = 0.63 [0.42-0.95]) in patients with ICAD. Multiple concomitant dissections tended to cluster on the same artery type rather than involving both a vertebral and carotid artery. Patients with ICAD had a less favorable 3-month functional outcome (modified Rankin Scale score >2, OR = 3.99 [2.32-6.88]), but this was no longer significant after adjusting for baseline NIHSS score. Conclusion: In the largest published series of patients with CEAD, we observed significant differences between VAD and ICAD in terms of risk factors, baseline features, and functional outcome. Neurology (R) 2011;77:1174-1181

引用

页码：1174 / 1181

页数：8

共 37 条

[21] Do extracellular-matrix-regulating enzymes play a role in cervical artery dissection? [J].