Clinical Manifestation and Prognostic Analysis on Spontaneous Vertebral Artery Dissection_West China Medical Journal

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Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China;

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Keywords：

椎动脉; 夹层; 影像学特征; 预后

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【摘要】目的 观察自发性椎动脉夹层（sVAD）的临床特点及预后。方法对2009年1月-2010年1月收治的15例经核磁共振血管成像和数字减影血管造影证实的sVAD患者，进行危险因素、临床表现、影像学特征、治疗及预后的全面分析。结果 15例sVAD患者，男10例，女5例；平均年龄40岁。12例有同侧头部、后颈部疼痛；13例发生后循环缺血性卒中，表现为延髓背外侧综合征者8例；14例给予抗凝治疗，1例予抗血小板治疗。随访6~12个月，MRS评分5例0分，9例1分，1例2分。结论 sVAD发病年龄较轻，男性居多。临床多表现为后循环缺血及后枕部或颈部疼痛，预后较好。
【Abstract】 Objective To observe the clinical manifestation and prognosis in patients with spontaneous vertebral artery dissection (sVAD). Methods Clinical data of 15 patients with sVAD who were confirmed by MRA and DSA from January 2009 to January 2010 were analyzed on risk factors,clinical symptoms,imaging features,treatment and 6-12 months prognosis. Results The patients were ten males and five females,with the average age of 40 years old. Twelve patients had pain in homolateral head and neck. Thirteen patients had stroke in posterior circulation, among which eight showed Wallenberg Syndrome. Anticoagulant therapy was given in 14 patients and antiplatelet treatment in one. Within 6-12 months follow-up, MRS scores were zero in five patients, one in nine patients, and two in one patient. Conclusion sVAD often occurres in young people, and mainly in men. Stroke in posterior circulation and pain are easily seen in sVAD, and most of them have favorable outcome.

Citation： LEI Lei,YANG Mi,HE Li. Clinical Manifestation and Prognostic Analysis on Spontaneous Vertebral Artery Dissection. West China Medical Journal, 2010, 25(9): 1611-1614. doi: Copy

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11.	Arnold M, Bousser MG, Fahrni G, et al. Vertebral artery dissection: presenting findings and predictors of outcome[J]. Stroke, 2006, 37(10): 2499-2503.
12.	Mokri B, Houser OW, Sandok BA, et al. Spontaneous dissection of the vertebral arteries[J]. Neurology, 1988, 38: 880-885.
13.	潘旭东, 王琨, 马爱军, 等. 延髓背外侧综合征病因自发性椎动脉夹层7例临床研究[J]. 中风与神经疾病杂志, 2009, 26(6): 733-735.
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1. Argenson C, Francke JP, Sylla S, et al. The vertebral arteries (segments Vl and V2)[J]. Anat Clin, 1980, 2: 29-41.
2. Francke JP, Di Marino V, Pannier M, et al. The vertebral arteries (arteria vertebralis): the V3 atlanto-axial and V4 intracranial segments-collaterals[J]. Anat Clin, 1981, 2: 229-242.
3. Redekop GJ. Extracranial carotid and vertebral artery dissection: a review[J]. Can J Neurol Sci, 2008, 35(2): 146-152.
4. Leys D, Bandu L, Hénon H, et al. Clinical outcome in 287 consecutive young adults (15 to 45 years) with ischemic stroke[J]. Neurology, 2002, 59(1): 26-33.
5. Taha MM, Nakahara I, Higashi T, et al. Endovascular embolization vs surgical clipping in treatment of cerebral aneurysms: morbidity and mortality with short-term outcome[J]. Surg Neurol, 2006, 66(3): 277-284.
6. Rothwell DM, Bondy SJ, Williams JI, et al. Chiropractic manipulation and stroke: a population-based case-control study[J]. Stroke, 2001, 32(5): 1054-1060.
7. Caso V, Paciaroni M, Bogousslavsky J. Environmental factors and cervical artery dissection[J]. Fron Neurol Neurosci, 2005, 20: 44-53.
8. Guillon B, Berthet K, Benslamia L, et al. Infection and the risk of spontaneous cervical artery dissection: a case-control study[J]. Stroke, 2003, 34(7): 79-81.
9. Paciaroni M, Georgiadis D, Arnold M, et al. Seasonal variability in spontaneous cervical artery dissection[J]. J Neurol Neurosurg Psychiatry, 2006, 77(5): 677-679.
10. Schievink WI, Mokri B, O′Fallon WM. Recurrent spontaneous cervical-artery dissection[J]. N Engl J Med, 1994, 330(6): 393-397.
11. Arnold M, Bousser MG, Fahrni G, et al. Vertebral artery dissection: presenting findings and predictors of outcome[J]. Stroke, 2006, 37(10): 2499-2503.
12. Mokri B, Houser OW, Sandok BA, et al. Spontaneous dissection of the vertebral arteries[J]. Neurology, 1988, 38: 880-885.
13. 潘旭东, 王琨, 马爱军, 等. 延髓背外侧综合征病因自发性椎动脉夹层7例临床研究[J]. 中风与神经疾病杂志, 2009, 26(6): 733-735.
14. Schievink WI. The treatment of spontaneous carotid and vertebral artery dissections[J]. Curr Opin Cardiol, 2000, 15(5): 316-321.

West China Medical Journal

Clinical Manifestation and Prognostic Analysis on Spontaneous Vertebral Artery Dissection

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