Differences in demographic characteristics and risk factors in patients with spontaneous vertebral artery dissections with and without ischemic events.
OBJECTIVE
Spontaneous vertebral artery dissection (sVADs) mainly cause cerebral ischemia, with or without associated local symptoms and signs (headache, neck pain, or cervical radiculopathy), or with local symptoms and signs only.


METHODS
We compared the presenting characteristics of consecutive patients with single sVADs and ischemic events and those with local symptoms and signs only.


RESULTS
Of the 186 patients with first-ever unilateral sVAD, 165 (89%) presented with cerebral ischemia, and 21 (11%) presented with local symptoms and signs only. Patients with sVAD and ischemia were more often male (63% vs 29%; P=0.002), older (mean+/-SD age, 43.6+/-9.9 vs 38.6+/-9.0 years; P=0.027), and smokers (14% vs 3%; P=0.010), but less often, they had a history of migraine without aura (17% vs 38%; P=0.025) than did patients without ischemia. The multivariate analysis confirmed independent associations between male sex (P=0.024), increasing age (0.027), and smoking (P=0.012) and sVADs causing cerebral ischemia.


CONCLUSIONS
These results suggest that men, older patients, and smokers with sVADs may be at increased risk for ischemic events.
Arnold
Marcel
M
Kurmann
Rebekka
R
Galimanis
Aekaterini
A
Sarikaya
Hakan
H
Stapf
Christian
C
Gralla
Jan
J
Georgiadis
Dimitrios
D
Fischer
Urs
U
Mattle
Heinrich P
HP
Bousser
Marie-Germaine
MG
Baumgartner
Ralf W
RW
D000328:Adult; D000367:Age Factors; D002545:Brain Ischemia / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D020217:Vertebral Artery Dissection / Q000150:complications / Q000503:physiopathology