title: Recurrent spontaneous arterial dissections: risk in familial versus nonfamilial disease.
abstract: OBJECTIVE
  Among patients with spontaneous cervical artery dissections, the risk of recurrent arterial dissection is relatively low at 1% per year, but this risk may be higher for patients with a family history of arterial dissections. We compared the risk of a recurrent arterial dissection in patients with familial versus non familial disease.
  
  
  METHODS
  Long-term follow-up was established in 200 patients (104 women and 96 men with a mean age of 44.9 years) with spontaneous cervical artery dissections evaluated at a single institution between 1970 and 1990.
  
  
  RESULTS
  Among the 200 patients, 10 (5%) were identified who had a family history of spontaneous arterial dissections. In a multivariate analysis, family history was the only significant variable associated with the risk of recurrent dissection (X2=15.51; P=.0001). A recurrent arterial dissection was identified in 5 (50%) of the 10 patients with familial disease compared with 11 (5.8%) of the 190 patients with nonfamilial disease, with an estimated relative risk of 6.3 (95% confidence interval, 2.2 to 18.3; P=.0007).
  
  
  CONCLUSIONS
  Among patients with spontaneous cervical artery dissections, a family history of arterial dissection is an important risk factor for the development of a recurrent arterial dissection.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: W I
authors.initials: WI
authors.lastname: Schievink
authors.forename: B
authors.initials: B
authors.lastname: Mokri
authors.forename: D G
authors.initials: DG
authors.lastname: Piepgras
authors.forename: J D
authors.initials: JD
authors.lastname: Kuiper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics*; D002533:Cerebral Angiography; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors