A nationwide study (VAD 2013) was conducted over a year (January 1 to December 31, 2011) to elucidate the recent trends of the clinical features, radiographic findings, treatment, and outcomes of non-traumatic intracranial arterial dissection in the vertebrobasilar system. Here, we present the outline of the study. In this study, 632 patients from 172 neurosurgical institutes were enrolled. They were divided into 3 groups: (1) hemorrhage group consisting of 193 (30.5%) patients with subarachnoid hemorrhage; (2) ischemia group consisting of 209 (33.1%) patients with brain infarction or transient ischemic attack; and (3) headache group consisting of 230 (36.4%) patients. The following patient characteristics were recorded: age, sex, location of arterial dissection, initial radiographic findings, and serial changes in these findings, treatment, follow-up periods, and mid-term outcomes. The outcomes were evaluated using the modified Rankin scale (mRS), and a good outcome was defined as an mRS score of 0-2. Results: (1) Age and sex: The median age of the patients was 53, 52, and 50 in the hemorrhage, ischemia, and headache groups, respectively. Men outnumbered women in all the 3 groups; especially, in the ischemia group, the number of men was remarkably higher than that of women. (2) Location of arterial dissection: The vertebral artery was affected in 85% of the patients in both the hemorrhage and ischemia groups, and in 97% of the patients in the headache group. (3) Radiographic findings: Fusiform dilatation and pearl-and-string sign were the common findings in the hemorrhage group, whereas tapering string and occlusion were more frequent in the ischemia group. Regarding serial changes of the radiographic findings, improvement of the finding was the most common, followed by no change in both the ischemia and headache groups.(4) Treatment: Surgical treatment was administered to 82% of the patients, and endovascular surgery was the main procedure adopted for the hem
The first nationwide survey for nontraumatic intracranial vertebrobasilar dissection (VAD) was conducted in Japan 20 years previously. The optimal treatment for ischemic VAD is still a controversial topic. We conducted a nationwide study over a 1-year period (2011) to examine the present status of management, outcomes, and factors influencing the outcome. The response rate for this survey was 15.6% (172 responses/1104 total facilities). Of the 632 patients with VAD that were enrolled to this study, 209 patients had ischemic VAD. The median age at onset was 50 (21-85) years and 78.5% of the patients were men. In this cohort, 56.7% of the patients experienced headache at the onset. Wallenberg syndrome, motor paresis, sensory disturbance, and cranial nerve symptoms were also observed in 36.9%, 22.4%, 46.7%, and 25.8% of the patients, respectively. Symptomatic deterioration and recurrence were observed in 44 patients (21.1%). With regard to patient management, 78.5% of the patients were treated with antithrombotic therapy. These
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.