Concomitant cervical spine fractures are the primary driver of disability after traumatic vertebral artery dissection: A Case series of 123 patients

Autor: Michael Brendan Cloney, Anastasios G Roumeliotis, Hooman A Azad, Nikil Prasad, Nathan A Shlobin, Benjamin S Hopkins, Babak S Jahromi, Matthew B Potts, Nader S Dahdaleh
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Craniovertebral Junction and Spine, Vol 13, Iss 4, Pp 410-414 (2022)
Druh dokumentu: article
ISSN: 0974-8237
DOI: 10.4103/jcvjs.jcvjs_111_22
Popis: Background: Traumatic vertebral artery dissections (tVADs) occur in up to 20% of patients with head trauma, yet data on their presentation and associated sequelae are limited. Aims and Objectives: To characterize the tVAD population and identify factors associated with clinical outcomes. Materials and Methods: We retrospectively analyzed all cases of tVAD at our institution from January 2004 to December 2018 with respect to mechanism of injury, clinical presentation, anatomic factors, associated pathologies, and relevant outcomes. Results: Of the 123 patients with tVAD, the most common presenting symptoms were neck pain (n=76, 67.3%), headache (57.5%), and visual changes (29.6%). 101 cases (82.1%) were unilateral, and 22 cases (17.9%) were bilateral. V2 was the most involved anatomic segment (83 cases, 70.3). 30 cases (25.4%) led to stroke, and 39 cases (31.7%) had a concomitant cervical fracture. The anatomic segment and number of segments involved, and baseline clinical and demographic characteristics were not associated with risk of stroke. Patients with associated fractures were older (50.3 years v. 36.4 years, p=0.0233), had a higher comorbid disease burden (CCI 1 vs. CCI 1, p
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