title: Do characteristics of dissection differ between the posterior inferior cerebellar artery and the vertebral artery?
abstract: OBJECTIVE
  The purpose of this study was to clarify the features of posterior inferior cerebellar artery (PICA) dissection.
  
  
  METHODS
  We prospectively registered 93 consecutive patients and 108 arteries with confirmed diagnoses of dissection in the vertebral artery (VA) or PICA between February 2007 and January 2014. Patients were diagnosed with arterial dissection when they had both acute symptoms and radiological characteristics in magnetic resonance imaging or digital subtraction angiography. Patients were divided into 2 groups depending on whether the site of dissection was VA (VA group) or PICA (PICA group). We compared the clinical and radiological characteristics and clinical outcomes of PICA versus VA dissection.
  
  
  RESULTS
  Of the 93 patients included in this study, 83 were in the VA group, and 10 had arterial dissection in the PICA. Patients with PICA dissection more frequently suffered from SAH (P < .001), whereas nonstroke symptom was often the initial symptom in the VA group. Pearl sign was seen most frequently at the dissection site of PICA. Surgical or endovascular treatment was performed in 9 of 10 PICA dissections, whereas more than half of the VA dissections were treated conservatively (P < .001). SAH was significantly more severe in the patients with PICA dissection compared with those in the VA group (P = .049).
  
  
  CONCLUSIONS
  Patients with PICA dissection suffered from subarachnoid hemorrhage more frequently than those with VA dissection. PICA dissection was treated with surgical intervention, whereas VA dissection was treated conservatively.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Japan.
authors.forename: Juntaro
authors.initials: J
authors.lastname: Matsumoto
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Japan; Department of Neurology, Faculty of Medicine, Fukuoka University, Japan. Electronic address: toshi.ogata1@gmail.com.
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Higashi
authors.affiliation: Department of Radiology, Faculty of Medicine, Fukuoka University, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Takano
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Japan.
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D015901:Angiography, Digital Subtraction; D002531:Cerebellum / Q000098:blood supply*; D002533:Cerebral Angiography / Q000379:methods; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy
keywords: Posterior inferior cerebellar artery; dissection; vertebral artery