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Academia Mexicana de Neurología, A.C.

2012, Number 1

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Rev Mex Neuroci 2012; 13 (1)

Differences between carotid and vertebral artery dissection: A hospital-based study with long-term follow-up in 215 patients

Araúz A, Ruíz A, Pacheco G, Rojas P, Márquez JM, Cantú C, Barinagarrementeria F

Language: Spanish
References: 21
Page: 8-14
PDF size: 193.47 Kb.


ABSTRACT

Objective: To analyzed whether risk factor profile, baseline features and prognosis of cervical artery dissection (CAD) differ according to the type and dissection site. Material and methods: We analyzed 215 consecutive patients diagnosed from January 1990 to January 2011 with confirmed diagnosis of ischemic stroke secondary to CAD. Results: Vertebral artery dissection (VAD) was present in 133 cases (62%). Two thirds of patients with VAD were men (65%). No differences were found between major vascular risk factors or history of trauma. Carotid artery dissection (CAD) was mainly extracranial (p= 0.0001) with occlusive dissection pattern (p = 0.0001) and worse functional outcome (modified Rankin scale 3-5; 56%). While in the cases of VAD, we most frequently found; multiple concomitant disease (p = 0.009), intracranial affection (p = 0.001), pattern of stenosis (p = 0.05) and very good functional outcome (modified Rankin scale 0-1; 45 vs. 17%). At follow-up, 14 patients died (6 carotid, 7 vertebrals) and 4 had a recurrence (3 carotid and 1 vertebral). Conclusion: In our series, vertebral dissection retrospredominates, especially in men, and with better longterm functional prognosis. We observe significant differences between VAD and CAD in terms of location and type of dissection. There is poor long-term recurrence.


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