Dissecção espontânea das artérias carótidas e vertebrais em uma população multiétnica

Abstract

RESUMO -A dissecção espontânea das artérias carótidas e vertebrais (DEACV) é considerada uma causa rara de acidente vascular cerebral, particularmente em países com população multiétnica. O objetivo desse estudo foi avaliar características clínicas e de neuroimagem dos pacientes com DEACV em uma população multiétnica. Foram estudados 66 pacientes com diagnóstico de DEACV em dois hospitais terciários de São Paulo. Aplicou-se um questionário inicial e os pacientes foram seguidos prospectivamente. Dos pacientes estudados, 82% eram brancos, 53% eram homens e a média de idade foi 41,7 anos. Os fatores de risco cardiovasculares mais freqüentes foram hipertensão arterial e tabagismo. Outros aspectos avaliados foram histó-ria prévia de enxaqueca, tratamento inicial e prognóstico. Concluiu-se que apesar da população estudada ser multiétnica, houve um marcante predomínio de brancos. A análise das características clínicas e de neuroimagem dos pacientes com DEACV possibilita um melhor conhecimento da doença, levando a um diagnóstico precoce e tratamento mais adequado.PALAVRAS-CHAVE: dissecação da artéria vertebral, dissecação da artéria carótida interna, acidente cerebrovascular, grupos étnicos. Spontaneous carotid and vertebral arteries dissection in a multiethnic populationABSTRACT -Spontaneous dissection of the carotid and vertebral arteries (SDCVA) is considered a rare cause of stroke, particularly in countries with multiethnic population. The objective was to evaluate the clinical and neuroimaging features of patients with SDCVA from a multiethnic population. Sixty-six patients diagnosed with SDCVA were studied at two tertiary hospitals at São Paulo. An initial questionnaire was completed and patients were followed prospectively. Among the patients studied, 82% were caucasian, 53% were male and the average age was 41.7 years old. The most frequent cardiovascular risk factors found were systemic hypertension and tobacco use. Other aspects evaluated were history of previous migraine, initial treatment and prognosis. In conclusion, although the population studied was multhiethnic, there was a marked predominance of caucasians. The analysis of clinical and neuroimaging data from patients with SDCVA allows a better understanding of the disease, leading to an earlier diagnosis and more appropriate treatment.KEY WORDS: vertebral artery dissection, carotid artery internal dissection, cerebrovascular disorder, ethnic groups. A dissecção espontânea das artérias carótidas e vertebrais (DEACV) caracteriza-se pela sua ruptura não traumática, entre as camadas arteriais, levando à redução do diâmetro da luz da artéria ou à formação de dilatação aneurismática . Novos estudos são necessários para o esclarecimento de dúvidas que ainda persistem quanto à etiologia, diagnóstico, tratamento e prognóstico dos pacientes com DEACV, especialmente em populações multiétnicas. O objetivo deste estudo foi descrever, a partir de uma série de casos, as características clínicas e os achados de neuroimagem mais freqüentemente observados nos pacientes ...

Migraine, migraine aura, and cervical artery dissection: A systematic review and meta-analysis

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“…One plausible link may be cervical artery dissection (CAD) (6), as CAD is one of the leading causes of ischemic stroke in the young (7). The association between migraine and CAD has been suggested by case series (8,9) and also in some case-control studies…”

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