Cervicocranial arterial dissection: experience of 73 patients in a single center

Huang, Yanxiong; Chen, Ya-Fang; Wang, Yao Hung; Tu, Yong Kwang; Jeng, Jiann‐Shing; Liu, Hon‐Man

doi:10.1016/j.surneu.2008.10.002

Cited by 72 publications

(75 citation statements)

References 16 publications

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“…Recurrence of dissection was presumed to be high in previous FMD reports (23.5–33%) but was not detected in our patients [34,38]. A previous report on Taiwanese patients with cervicocranial dissection showed no recurrence during follow-up [39]. This may explain the low incidence of recurrent stroke in our series.…”

Section: Discussioncontrasting

confidence: 44%

Cervicocranial Fibromuscular Dysplasia in Taiwanese Ischemic Stroke Patients

Liu

Wu²,

Chin³

et al. 2012

Eur Neurol

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Introduction: Clinical research of cervicocranial fibromuscular dysplasia (FMD) is rare in Asian populations. Our study reviewed Taiwanese ischemic stroke patients with cervicocranial FMD and compared them with previous reports. Methods: Between 2000 and 2011, we collected 19 consecutive cervicocranial FMD patients who received demographic registration, a blood test for excluding vasculitis, and comprehensive angiography. Cerebral ultrasound, vascular images and clinical outcomes (Barthel index, modified Rankin scale, recurrent stroke, or death) were monitored during follow-up. Results: Of the 19 patients, 16 (84%) had carotid FMD, while 7 (37%) had vertebral FMD. Only 2 investigated patients (13%) had renal FMD and 1 (5%) had cerebral aneurysm. 14 (74%) presented acute arterial dissection. All patients received medical treatment and had neither recurrent stroke nor dissection during follow-up. In the literature review of 225 FMD patients, 3.6% had recurrent stroke during follow-up, and some reported surgical procedure or angioplasty could give a good clinical outcome in progressing ischemia irrelevant to the cause of stenosis. Conclusion: In Taiwanese cervicocranial FMD patients, arterial dissection was one of the most common clinical presentations. Most of our patients had isolated involvement of the cervicocranial artery and carried a favorable outcome under medical treatment.

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Section: Discussioncontrasting

confidence: 44%

Cervicocranial Fibromuscular Dysplasia in Taiwanese Ischemic Stroke Patients

Liu

Wu²,

Chin³

et al. 2012

Eur Neurol

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“…17 In a Mexican study 18 of 100 patients admitted to a neurology department for vertebral artery dissection with ischaemic stroke and without subarachnoid haemor rhage, 27 (27%) patients had intracranial artery dissection. In studies undertaken in east Asia, [19][20][21][22][23] in which patients were mostly recruited through neuro surgery and interventional neuroradiology departments, intracranial artery dissection Review accounted for up to 67-78% of all cervicocephalic artery dissections. 19,20 Most reported series of patients with intracranial artery dissection are from Asia (95% of studies including >40 patients with intracranial artery dissection, and 61% of studies including 20-39 patients with this disorder).…”

Section: Epidemiologymentioning

confidence: 99%

“…In studies undertaken in east Asia, [19][20][21][22][23] in which patients were mostly recruited through neuro surgery and interventional neuroradiology departments, intracranial artery dissection Review accounted for up to 67-78% of all cervicocephalic artery dissections. 19,20 Most reported series of patients with intracranial artery dissection are from Asia (95% of studies including >40 patients with intracranial artery dissection, and 61% of studies including 20-39 patients with this disorder). Whether this suggests publication bias, diff erences in disease prevalence across ethnic origin groups, or both, is unclear.…”

Section: Epidemiologymentioning

confidence: 99%

Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

Debette¹,

Compter²,

Labeyrie³

et al. 2015

The Lancet Neurology

362

351

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Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defi ned by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with mass eff ect, mostly on the brainstem. Although intracranial artery dissection is less common than cervical artery dissection in adults of European ethnic origin, intracranial artery dissection is reportedly more common in children and in Asian populations. Risk factors and mechanisms are poorly understood, and diagnosis is challenging because characteristic imaging features can be diffi cult to detect in view of the small size of intracranial arteries. Therefore, multimodal follow-up imaging is often needed to confi rm the diagnosis. Treatment of intracranial artery dissections is empirical in the absence of data from randomised controlled trials. Most patients with subarachnoid haemorrhage undergo surgical or endovascular treatment to prevent rebleeding, whereas patients with intracranial artery dissection and cerebral ischaemia are treated with antithrombotics. Prognosis seems worse in patients with subarachnoid haemorrhage than in those without.

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“…The vertebral artery, which is involved in up to 81.6% of cases, is the most commonly involved artery in spontaneous posterior circulation dissections 11 . These dissections are associated with a mortality rate ranging between from 19 to 83% 12 .…”

Section: Epidemiologymentioning

confidence: 99%

Intracranial Vertebral Artery Dissections: Evolving Perspectives

et al. 2012

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Intracranial vertebral artery dissection (VAD) represents the underlying etiology in a significant percentage of posterior circulation ischemic strokes and subarachnoid hemorrhages. These lesions are particularly challenging in their diagnosis, management, and in the prediction of long-term outcome. Advances in the understanding of underlying processes leading to dissection, as well as the evolution of modern imaging techniques are discussed. The data pertaining to medical management of intracranial VADs, with emphasis on anticoagulants and antiplatelet agents, is reviewed. Surgical intervention is discussed, including, the selection of operative candidates, open and endovascular procedures, and potential complications. The evolution of endovascular technology and techniques is highlighted.

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Cervicocranial arterial dissection: experience of 73 patients in a single center

Cited by 72 publications

References 16 publications

Cervicocranial Fibromuscular Dysplasia in Taiwanese Ischemic Stroke Patients

Cervicocranial Fibromuscular Dysplasia in Taiwanese Ischemic Stroke Patients

Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

Intracranial Vertebral Artery Dissections: Evolving Perspectives

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