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
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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