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Differences in demographic characteristics and risk factors in patients with spontaneous vertebral artery dissections with and without ischemic events


Arnold, M; Kurmann, R; Galimanis, A; Sarikaya, H; Stapf, C; Gralla, J; Georgiadis, D; Fischer, U; Mattle, H P; Bousser, M G; Baumgartner, R W (2010). Differences in demographic characteristics and risk factors in patients with spontaneous vertebral artery dissections with and without ischemic events. Stroke, 41(4):802-804.

Abstract

BACKGROUND AND PURPOSE: Spontaneous vertebral artery dissection (sVADs) mainly cause cerebral ischemia, with or without associated local symptoms and signs (headache, neck pain, or cervical radiculopathy), or with local symptoms and signs only. METHODS: We compared the presenting characteristics of consecutive patients with single sVADs and ischemic events and those with local symptoms and signs only. RESULTS: Of the 186 patients with first-ever unilateral sVAD, 165 (89%) presented with cerebral ischemia, and 21 (11%) presented with local symptoms and signs only. Patients with sVAD and ischemia were more often male (63% vs 29%; P=0.002), older (mean+/-SD age, 43.6+/-9.9 vs 38.6+/-9.0 years; P=0.027), and smokers (14% vs 3%; P=0.010), but less often, they had a history of migraine without aura (17% vs 38%; P=0.025) than did patients without ischemia. The multivariate analysis confirmed independent associations between male sex (P=0.024), increasing age (0.027), and smoking (P=0.012) and sVADs causing cerebral ischemia. CONCLUSIONS: These results suggest that men, older patients, and smokers with sVADs may be at increased risk for ischemic events.

BACKGROUND AND PURPOSE: Spontaneous vertebral artery dissection (sVADs) mainly cause cerebral ischemia, with or without associated local symptoms and signs (headache, neck pain, or cervical radiculopathy), or with local symptoms and signs only. METHODS: We compared the presenting characteristics of consecutive patients with single sVADs and ischemic events and those with local symptoms and signs only. RESULTS: Of the 186 patients with first-ever unilateral sVAD, 165 (89%) presented with cerebral ischemia, and 21 (11%) presented with local symptoms and signs only. Patients with sVAD and ischemia were more often male (63% vs 29%; P=0.002), older (mean+/-SD age, 43.6+/-9.9 vs 38.6+/-9.0 years; P=0.027), and smokers (14% vs 3%; P=0.010), but less often, they had a history of migraine without aura (17% vs 38%; P=0.025) than did patients without ischemia. The multivariate analysis confirmed independent associations between male sex (P=0.024), increasing age (0.027), and smoking (P=0.012) and sVADs causing cerebral ischemia. CONCLUSIONS: These results suggest that men, older patients, and smokers with sVADs may be at increased risk for ischemic events.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2010
Deposited On:16 Jul 2010 14:12
Last Modified:05 Apr 2016 14:11
Publisher:Lippincott Wiliams & Wilkins
ISSN:0039-2499
Publisher DOI:10.1161/STROKEAHA.109.570655
PubMed ID:20185787
Permanent URL: http://doi.org/10.5167/uzh-34881

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