Stroke. 2010 Apr;41(4):802-4. doi: 10.1161/STROKEAHA.109.570655. Epub 2010 Feb 25.
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.
We compared the presenting characteristics of consecutive patients with single sVADs and ischemic events and those with local symptoms and signs only.
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.
These results suggest that men, older patients, and smokers with sVADs may be at increased risk for ischemic events.
自发性椎动脉夹层（sVAD）主要导致脑缺血，伴有或不伴有局部症状和体征（头痛、颈痛或神经根病），或仅有局部症状和体征。
我们比较了连续患有单发 sVAD 和缺血事件的患者以及仅有局部症状和体征的患者的表现特征。
在 186 例首次单侧 sVAD 患者中，165 例（89%）表现为脑缺血，21 例（11%）仅表现为局部症状和体征。患有 sVAD 和缺血的患者更常为男性（63%比 29%；P=0.002）、年龄更大（平均+/-标准差年龄，43.6+/-9.9 比 38.6+/-9.0 岁；P=0.027）和吸烟者（14%比 3%；P=0.010），但患有偏头痛无先兆（17%比 38%；P=0.025）的患者较少。多变量分析证实，男性（P=0.024）、年龄增加（P=0.027）和吸烟（P=0.012）与 sVAD 引起脑缺血之间存在独立关联。
这些结果表明，sVAD 患者中男性、年龄较大的患者和吸烟者发生缺血事件的风险可能增加。
