Comparison of spontaneous intracranial vertebral artery dissection with large artery disease

Soo Lee Jin, Woo Yong Seok, Young Bang Oh, Sam Shin Yong, Moon Kim Byung, Yong Kim Sun

Research output: Contribution to journalArticle

13 Citations (Scopus)

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). Design: Retrospective study. Setting: 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. Main Outcome Measures: 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). Conclusion: 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.

Original languageEnglish
Pages (from-to)1738-1744
Number of pages7
JournalArchives of Neurology
Volume63
Issue number12
DOIs
Publication statusPublished - 2006 Dec 1

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Vertebral Artery Dissection
Arteries
Vertebral Artery
Stroke
Pathologic Constriction
Cerebrovascular Disorders
Headache Disorders
Dissection
Tertiary Care Centers
Blood Vessels
Headache
Atherosclerosis
Angiography
Differential Diagnosis
Retrospective Studies
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

Jin, Soo Lee ; Seok, Woo Yong ; Oh, Young Bang ; Yong, Sam Shin ; Byung, Moon Kim ; Sun, Yong Kim. / Comparison of spontaneous intracranial vertebral artery dissection with large artery disease. In: Archives of Neurology. 2006 ; Vol. 63, No. 12. pp. 1738-1744.
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Comparison of spontaneous intracranial vertebral artery dissection with large artery disease. / Jin, Soo Lee; Seok, Woo Yong; Oh, Young Bang; Yong, Sam Shin; Byung, Moon Kim; Sun, Yong Kim.

In: Archives of Neurology, Vol. 63, No. 12, 01.12.2006, p. 1738-1744.

Research output: Contribution to journalArticle

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N2 - Objective: To compare clinical and angiographic characteristics and stroke patterns between spontaneous intracranial vertebral artery dissection (VAD) and vertebral large artery disease (LAD) (atherosclerosis). Design: Retrospective study. Setting: 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. Main Outcome Measures: 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). Conclusion: 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.

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