title: Comparison of spontaneous intracranial vertebral artery dissection with large artery disease.
abstract: OBJECTIVE
  To compare clinical and angiographic characteristics and stroke patterns between spontaneous intracranial vertebral artery dissection (VAD) and vertebral large artery disease (LAD) (atherosclerosis).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary referral center for cerebrovascular diseases. Patients Twenty-two patients with spontaneous VAD and 25 with LAD in the intracranial portion of the vertebral artery.
  
  
  METHODS
  We compared (1) clinical characteristics, including epidemiologic data, vascular risk factors including inflammatory markers, the presence of headache, and stroke syndromes and severity; (2) stroke pattern on diffusion-weighted imaging, which was classified as vertebral perforator infarct, basilar perforator infarct, small scattered infarct, large scattered infarct, and territorial infarct; and (3) angiographic findings, ie, the distribution of involved arteries, degree of stenosis, and the involvement on the anterior circulation and calcification of vertebral artery.
  
  
  RESULTS
  Although patients with VAD were younger, and more often had headaches and fewer vascular risk factors than those with LAD (P<.01 in all cases), these clinical features were also observed in some LAD patients. Diffusion-weighted imaging data showed that vertebral perforator infarct and small scattered infarct were most common in the VAD group, while territorial infarct and large scattered infarct were most common in the LAD group (P = .02). On angiography, LAD more frequently had anterior circulation arterial involvement (P = .002), higher degree of stenosis (P = .002), and calcifications (P = .008).
  
  
  CONCLUSIONS
  Our findings indicate that results of diffusion-weighted imaging and noninvasive vascular studies might provide clues to the clinical characteristics in differential diagnosis between VAD and LAD.
authors.affiliation: Departments of Neurology, Neurosurgery, and Neuroradiology, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Seok Woo
authors.initials: SW
authors.lastname: Yong
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Bang
authors.forename: Yong Sam
authors.initials: YS
authors.lastname: Shin
authors.forename: Byung Moon
authors.initials: BM
authors.lastname: Kim
authors.forename: Sun Yong
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000473:pathology; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D020217:Vertebral Artery Dissection / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*