Hepatitis-C-Associated Multiple Arterial Dissection of Cerebral Vessels

Hamann, Gerhard F.; Zachoval, R.; Einsiedel, H. von; Sander, Dorothea

doi:10.1159/000069072

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…20 HCV infection is reported to be associated with dissection of the cerebral artery and a cause of SAH. 21 These lines of evidence appear to suggest that known or unknown infectious agents might be involved in the pathogenesis of SAH through transfusions.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Fatal Subarachnoid Hemorrhage

Yamada

Iso²,

Wada³

et al. 2003

Stroke

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MD; for the JACC Study GroupBackground and Purpose-The present study aimed to identify risk factors for mortality due to subarachnoid hemorrhage (SAH) using a comprehensive questionnaire from the Japan Collaborative Cohort (JACC) Study, a Japan-wide population-based prospective study. Methods-A total of 109 293 individuals (45 551 men and 63 742 women, aged 40 to 79 years) free of stroke at entry participated in the JACC Study between 1988 and 1990. Participants were followed up annually until they died or moved away from the surveyed community, or until the end of 1999. A diagnosis of death from SAH was based on the International Classification of Diseases, 10th revision (ICD-10). The age-adjusted univariate and multivariate hazard ratios (HR) and 95% confidence intervals (CI) of various factors were calculated in sex-stratified and sex-specific analyses using the Cox proportional hazards regression model. Results-A total of 244 individuals (88 men and 156 women) died from SAH during the follow-up of 1 086 963 person-years. Our univariate analyses confirmed that preference for salty foods and history of blood transfusion, as well as hypertension, family history of stroke, cigarette smoking, heavy alcohol consumption, and low BMI, had statistically significant associations with mortality due to SAH. Multivariable analyses revealed that history of blood transfusion was an independent significant risk factor (HRϭ4.2 [95%CI, 2.1 to 8.5]) for men, while preference for salty foods or heavy drinking were not. Conclusions-History of blood transfusion was found to be an independent risk. The association between SAH and blood transfusion warranted further study.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Fatal Subarachnoid Hemorrhage

Yamada

Iso²,

Wada³

et al. 2003

Stroke

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“…On the other hand, many recent reports indicate that chronic inflammatory reaction to transfusion-transmitted infections promotes atherosclerotic vascular changes [18,19,20,21,22,23,24,25]. Helicobacter pylori , Chlamydia pneumoniae , herpes simplex virus, CMV and HCV have been reported to be pathogens of atherosclerosis [18, 19, 25].…”

Section: Discussionmentioning

confidence: 99%

“…Helicobacter pylori , Chlamydia pneumoniae , herpes simplex virus, CMV and HCV have been reported to be pathogens of atherosclerosis [18, 19, 25]. These observations led us to hypothesize that transfusion history is a risk factor for stroke and CHD through chronic inflammations caused by transfusion-transmitted infection.…”

Section: Discussionmentioning

confidence: 99%

“…Another mechanism could be chronic inflammation caused by various infectious agents transmitted by transfusion. This mechanism has been considered as a risk factor for atherosclerosis [18,19,20,21,22,23,24,25]. If so, one may wonder whether the risks of mortality from other stroke or cardiovascular diseases (CVD) may also be elevated by transfusion.…”

Section: Introductionmentioning

confidence: 99%

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History of Blood Transfusion before 1990 Is a Risk Factor for Stroke and Cardiovascular Diseases: The Japan Collaborative Cohort Study (JACC Study)

Yamada

Iso²,

Wada³

et al. 2005

Cerebrovasc Dis

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Background: We have previously shown novel evidence that history of blood transfusion is a risk factor for mortality from subarachnoid hemorrhage. This study was conducted to assess history of transfusion as a risk factor for other hemorrhagic stroke or ischemic stroke and cardiovascular diseases. Study Design and Methods: A total of 88,312 Japanese participants (36,823 men and 51,489 women), aged 40–79 years, without history of stroke, heart disease or cancer, completed a questionnaire including history of transfusion under the JACC Study from 1988 to 1990. Participants were followed up annually until deceased, or when they moved away from the surveyed community, or at the end of 1999. The underlying causes of death were determined according to the International Classification of Diseases, 10th revision (ICD-10). Results: Total follow-up person-years were 871,437 (males 359,437, females 512,000). During this 10-year period, 309 died from intracerebral hemorrhage, 587 from ischemic stroke and 472 from coronary heart disease. The multivariate relative risks of a transfusion history were 2.16 (95% CI 1.42–3.27, p < 0.001) for intracerebral hemorrhage, 1.63 (95% CI 1.18–2.27, p = 0.004) for ischemic stroke and 1.66 (95% CI 1.17–2.36, p = 0.005) for coronary heart disease, after adjustment for conventional cardiovascular risk factors. Conclusion: A transfusion history was associated with increased mortality from stroke and coronary heart disease.

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Cerebrovascular Dissections—A Review Part I: Spontaneous Dissections

2011

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Spontaneous cerebrovascular dissections are subintimal or subadventitial cervical carotid and vertebral artery wall injuries and are the cause of as many as 2% of all ischemic strokes. Spontaneous dissections are the leading cause of stroke in patients younger than 45 years of age, accounting for almost one fourth of strokes in this population. A history of some degree of trivial trauma is present in nearly one fourth of cases. Subsequent mortality or neurological morbidity is usually the result of distal ischemia produced by emboli released from the injury site, although local mass effect produced by arterial dilation or aneurysm formation also can occur. The gold standard for diagnosis remains digital subtraction angiography. Computed tomography angiography, magnetic resonance angiography, and ultrasonography are complementary means o evaluation, particularly for injury screening or treatment follow-up. The annual rate of stroke after injury is approximately 1% or less per year. The currently accepted method of therapy remains antithrombotic medication, either in the form of anticoagulation or antiplatelet agents; however, no class I medical evidence exists to guide therapy. Other options for treatment include thrombolysis and endovascular therapy, although the efficacy and indications for these methods remain unclear.

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Hepatitis-C-Associated Multiple Arterial Dissection of Cerebral Vessels

Cited by 3 publications

References 5 publications

Risk Factors for Fatal Subarachnoid Hemorrhage

Risk Factors for Fatal Subarachnoid Hemorrhage

History of Blood Transfusion before 1990 Is a Risk Factor for Stroke and Cardiovascular Diseases: The Japan Collaborative Cohort Study (JACC Study)

Cerebrovascular Dissections—A Review Part I: Spontaneous Dissections

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