Spontaneous vertebral artery dissection: Report of 16 cases

Gui, Li; Shi, Gui-Shu; Li, Guangjian; Wang, Fan; Huang, Heqing; Zhou, Zheng-Hua; Chen, Kangning

doi:10.4103/0028-3886.73749

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…After elimination of duplicates and non-relevant records, 57 full-text articles were reviewed. After application of all inclusion and exclusion criteria, 16 studies (i.e., eleven East Asian studies 15 16 17 18 19 20 21 22 23 24 25 and five non-East Asian studies 26 27 28 29 30 ) were finally included in this meta-analysis ( Table 1 ). The quality assessment for these included studies is detailed in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

Endovascular versus Non-Interventional Therapy for Cervicocranial Artery Dissection in East Asian and Non-East Asian Patients: a Systematic Review and Meta-analysis

Huang

Niu

Wang

et al. 2015

Sci Rep

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Endovascular methods have been increasingly applied in treating cervicocranial artery dissection (CCAD). Anti-thrombotic therapy, which is used in non-interventional care of CCAD patients, has differential effects in East Asian patients. Therefore, we aimed to compare the clinical outcomes of endovascular versus non-interventional therapy for CCAD in East Asians and non-East Asians. A search was performed for studies comparing endovascular and non-interventional approaches to CCAD patients. Rates of recovery, disability, and mortality were used to assess these approaches in East Asian and non-East Asian patients. Subgroup analyses were conducted for CCAD patients with ruptured dissections. Eleven East Asian studies and five non-East Asian studies were included. The subgroup analyses for CCAD patients with ruptured dissections on mortality (East Asian odds ratio [OR] [95% confidence interval [CI]]: 0.24 [0.08-0.71], P = 0.01; I2 = 34%) and good recovery (East Asian OR [95% CI]: 3.79 [1.14-12.60], P = 0.03; I2 = 54%) revealed that endovascular therapy is significantly superior to non-interventional therapy for East Asians. No differences in treatment effect upon mortality, disability, or good recovery outcomes were found for the CCAD populations-at-large nor for non-East Asian CCAD patients with ruptured dissections. Endovascular therapy appears to be superior to non-interventional therapy for East Asian CCAD patients with ruptured dissections.

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Section: Resultsmentioning

confidence: 99%

Endovascular versus Non-Interventional Therapy for Cervicocranial Artery Dissection in East Asian and Non-East Asian Patients: a Systematic Review and Meta-analysis

Huang

Niu

Wang

et al. 2015

Sci Rep

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“…These include, but are not limited to, dizziness, nausea, vomiting, double vision, vertigo, ataxia, and dysarthria. Cerebellar infarction and lateral medullary (Wallenberg syndrome) are the most common types of strokes (cases 1 and 2 respectively) [10]. The clinical presentations of intracranial VAD are similar to extracranial symptoms, but usually associated with more severe neurological deficits; moreover, about half of intracranial VAD cases are associated with thunderclap headache due to subarachnoid hemorrhage (SAH), which results from a ruptured dissected vessel or pseudoaneurysm [11].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Vertebral Artery Dissection Is an Under-Recognized Cause of Stroke in Young Patients: Two Case Reports and Review

Elkady

Ghazal

Alanzi

et al. 2020

Cureus

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Cervicocerebral artery dissection (CAD) is an important and under-recognized cause of strokes in young and middle-aged patients. Spontaneous vertebral artery dissection (VAD) is a rare condition that can potentially cause a stroke without any preceding trauma or other causes of dissection. VAD rarely simulates classical headache syndromes. In this report, we discuss two young patients who were initially misdiagnosed as cases of headache until they presented with ischemic events, and were eventually diagnosed with spontaneous VAD. Case 1 involves a 41year-old male patient who presented with severe headache radiating to left posterior neck pain and dizziness. He was initially misdiagnosed as a case of cervicogenic headache. He was subsequently diagnosed with extracranial VAD complicated by a delayed embolic ischemic stroke. However, he made full recovery within the next few days. Case 2 pertains to a 33-yearold female patient who presented with right-sided headache mimicking migraine; later on, new neurological signs prompted a diagnosis of acute ischemic infarction as a complication of intracranial VAD. In conclusion, VAD should be seriously considered when dealing with patients complaining of the first attack of headache that mimics migraine or those with cervicogenic headaches, which fail to respond to the usual treatment. Moreover, posterior circulation stroke among young patients or stroke with pain in the head and neck should be investigated carefully with extensive neuroimaging. Finally, prompt and accurate diagnosis of VAD followed by proper treatment is crucial for good outcomes and will prevent disability or even fatal complications in patients.

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“…Vertebral artery dissection is a potential cause of posterior circulation ischemia that requires high-spatial-resolution imaging for the definitive diagnosis [1]. Digital subtraction angiography (DSA) remains the gold standard for assessment of the vertebrobasilar arteries, with excellent spatial and temporal resolution [2, 3].…”

Section: Introductionmentioning

confidence: 99%

MR diagnosis of vertebral artery dissection: value of 3D time-of-flight and true fast imaging with steady-state precession fusion imaging

Kidoh

Nakaura

Takashima³

et al. 2012

Insights Imaging

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ObjectivesWe hypothesized that 3D time-of-flight (TOF) and true fast imaging with steady-state precession (true-FISP) fusion imaging could provide more information regarding the arterial vessel wall. The purpose of this study was to compare the accuracy of lesion detection and the diagnostic confidence of VAD between TOF images alone and fused TOF and true-FISP images.MethodsFifty patients were studied: 17 had VAD and 33 had vertebral artery hypoplasia. Fusion images of the vertebral artery were reconstructed using a workstation. A receiver-operating characteristic (ROC) analysis was conducted with a continuous rating scale from 1 to 100 to compare observer performance in VAD detection. Five radiologists participated in the observer performance test, and their performances with TOF images were compared with those using fused images.ResultThe observers found that the mean areas under the best-fit ROC curve for TOF images alone and fused TOF images were 0.66 ± 0.05 and 0.93 ± 0.04, which were significantly different (P < 0.01).ConclusionThe fusion images provided more information regarding the arterial vessel wall. Fused images aided distinction between vertebral artery dissection versus vertebral artery hypoplasia.Key Points• New MR techniques can help to differentiate flowing blood from static blood products.• Fused TOF and true-FISP images differentiate the lumen and the arterial wall, improving diagnostic performance.• Fused images may be superior to time-of-flight MR angiography alone.

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Spontaneous vertebral artery dissection: Report of 16 cases

Abstract: Rapid and accurate diagnosis of sVAD and proper treatment are crucial for good outcomes. This study shows that antiplatelet therapy and endovascular treatment are effective treatments for sVAD.

Cited by 6 publications

References 23 publications

Endovascular versus Non-Interventional Therapy for Cervicocranial Artery Dissection in East Asian and Non-East Asian Patients: a Systematic Review and Meta-analysis

Endovascular versus Non-Interventional Therapy for Cervicocranial Artery Dissection in East Asian and Non-East Asian Patients: a Systematic Review and Meta-analysis

Spontaneous Vertebral Artery Dissection Is an Under-Recognized Cause of Stroke in Young Patients: Two Case Reports and Review

MR diagnosis of vertebral artery dissection: value of 3D time-of-flight and true fast imaging with steady-state precession fusion imaging

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