The Comparison of Clinical Findings and Treatment Between Unilateral and Bilateral Vertebral Artery Dissection
Autor: | Koichi Takano, Takashi Morishita, Masaki Takahara, Tooru Inoue, Toshiyasu Ogata, Toshio Higashi, Hiroshi Abe |
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Rok vydání: | 2019 |
Předmět: |
Adult
Brain Infarction Male medicine.medical_specialty Subarachnoid hemorrhage Clinical Decision-Making Infarction Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents String sign Predictive Value of Tests Risk Factors Hematologic Agents parasitic diseases Occlusion medicine Humans cardiovascular diseases Vertebral Artery Aged Vertebral Artery Dissection business.industry Medical record Endovascular Procedures Rehabilitation Angiography Digital Subtraction Anticoagulants Middle Aged Subarachnoid Hemorrhage medicine.disease Magnetic Resonance Imaging Cerebral Angiography Surgery Stenosis Dissection Treatment Outcome Bilateral vertebral artery dissection Female Neurology (clinical) biological phenomena cell phenomena and immunity Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors 030217 neurology & neurosurgery |
Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 28:1192-1199 |
ISSN: | 1052-3057 |
Popis: | There are limited clinical studies of bilateral vertebral artery dissection (VAD).To compare the characteristics, imaging findings, and treatments between patients with bilateral and unilateral VAD.Between February 2007 and May 2017, 31 (mean age: 53.0 years; 23 men, 8 women) out of 171 VAD patients were hospitalized because of bilateral VAD. Onset type, dissection site, dominant side of the VA, imaging features, treatments, and outcomes were investigated based on medical records. The dominant side of the VA was determined by basi-parallel anatomical scanning.Twenty (64.5%) of 31 patients exhibited bilateral VAD on both sides of V4. The dominant side of the VA was right in 16 patients and left in 15 patients. The pearl and string sign (an angiographical finding with both dilatation and stenosis) was frequently observed on the dominant VAD side, while a tapered occlusion and string sign were most common on the nondominant side. For clinical subtype of VAD, 6 (19.4%) patients had subarachnoid hemorrhage, 10 (32.3%) ischemic stroke, 3 (9.7%) infarction plus subarachnoid hemorrhage, and 12 (38.7%) only headache. The frequency of infarction was increased in bilateral VAD compared with unilateral (P.05). Surgical intervention was performed in 3 cases, while 14 patients received endovascular intervention.Infarction occurred frequently in bilateral VAD patients, and 17 patients required an intervention (mainly endovascular) for VA. The treatment strategy varied depending on the clinical subtype, imaging findings of VAD, and morphology of the dominant VAD side. |
Databáze: | OpenAIRE |
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