Paciaroni M, Georgiadis D, Arnold M, Gandjour J, Keseru B, Fahrni G, Caso V, Baumgartner R W
Stroke Unit, University Hospital Perugia, Italy.
J Neurol Neurosurg Psychiatry. 2006 May;77(5):677-9. doi: 10.1136/jnnp.2005.077073.
We examined the seasonal variability of spontaneous cervical artery dissection (sCAD) by analysing prospectively collected data from 352 patients with 380 sCAD (361 symptomatic sCAD; 305 carotid and 75 vertebral artery dissections) admitted to two university hospitals with a catchment area of 2,200,000 inhabitants between 1985 and 2004. Presenting symptoms and signs of the 380 sCAD were ischaemic stroke in 241 (63%), transient ischaemic attack in 40 (11%), retinal ischemia in seven (2%), and non-ischaemic in 73 (19%) cases; 19 (5%) were asymptomatic sCAD. A seasonal pattern, with higher frequency of sCAD in winter (31.3%; 95% confidence interval (CI): 26.5 to 36.4; p=0.021) compared to spring (25.5%; 95% CI: 21.1 to 30.3), summer (23.5%; 95% CI: 19.3 to 28.3), and autumn (19.7%; 95% CI: 15.7 to 24.1) was observed. Although the cause of seasonality in sCAD is unclear, the winter peaks of infection, hypertension, and aortic dissection suggest common underlying mechanisms.
我们通过分析1985年至2004年间前瞻性收集的352例自发性颈动脉夹层（sCAD）患者（共380次sCAD发作，其中361次为症状性sCAD；305次为颈动脉夹层，75次为椎动脉夹层）的数据，研究了sCAD的季节性变化。这380次sCAD发作的症状和体征包括：241例（63%）为缺血性卒中，40例（11%）为短暂性脑缺血发作，7例（2%）为视网膜缺血，73例（19%）为非缺血性症状；19例（5%）为无症状性sCAD。我们观察到一种季节性模式，与春季（25.5%；95%置信区间（CI）：21.1至30.3）、夏季（23.5%；95%CI：19.3至28.3）和秋季（19.7%；95%CI：15.7至24.1）相比，冬季sCAD发作频率更高（31.3%；95%CI：26.5至36.4；p=0.021）。尽管sCAD季节性变化的原因尚不清楚，但感染、高血压和主动脉夹层在冬季的高发提示了共同的潜在机制。
