Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China.
Department of Neurology, First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, China.
BMC Neurol. 2020 Dec 10;20(1):445. doi: 10.1186/s12883-020-02020-8.
Cervicocerebral artery dissection is an important cause of ischemic stroke in young and middle-aged individuals. However, very few studies have compared the differential features between internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD), including both cervical and intracranial artery dissections. We conducted a study to investigate the predisposing factors and radiological features in patients with ICAD or VAD.
All cases diagnosed with cervicocerebral artery dissection, ICAD, or VAD were identified through a medical records database, between January 2010 and January 2020. Baseline characteristics, predisposing factors, and radiological features of ICAD versus VAD were compared.
A total of 140 patients with cervicocerebral artery dissection were included in the study, including 84 patients in the ICAD group and 56 in the VAD group. The mean age of patients in the ICAD and VAD groups was 43.37 ± 14.01 and 41.00 ± 12.98 years old, respectively. Patients with ICAD were more likely to be men compared with VAD (85.71% vs. 67.86%, p = 0.012). The frequency of hypertension, diabetes, smoking, drinking, and cervical trauma did not differ between ICAD and VAD. Dissections of ICAD were more frequently at the extracranial portions of the artery compared with those of VAD (70.24% vs. 44.64%, p = 0.003). In contrast, dissections of VAD were more common in the intracranial artery (55.36% vs. 29.76%, p = 0.003). Radiologically, double lumen (36.90% vs. 19.64%, p = 0.029) and intimal flap (11.90% vs. 1.79%, p = 0.029) were more frequently observed in ICAD than in VAD, and dissecting aneurysms were less frequent (13.10% vs. 26.79%, p = 0.041).
The distributions of cervical and intracranial artery dissections were different between ICAD and VAD. The frequencies of radiological features detected in patients with ICAD and VAD also differed.
颈内动脉夹层（ICAD）和椎动脉夹层（VAD）是中青年缺血性脑卒中的重要病因，但目前鲜有研究比较颈内动脉和椎动脉夹层在发病因素和影像学特征方面的差异。我们进行了一项研究，旨在探讨 ICAD 和 VAD 患者的易患因素和影像学特征。
通过病历数据库，检索 2010 年 1 月至 2020 年 1 月期间诊断为颈内动脉夹层、ICAD 或 VAD 的所有患者。比较 ICAD 与 VAD 患者的基线特征、易患因素和影像学特征。
共纳入 140 例颈内动脉夹层患者，其中 ICAD 组 84 例，VAD 组 56 例。ICAD 组和 VAD 组患者的平均年龄分别为 43.37±14.01 岁和 41.00±12.98 岁。与 VAD 组相比，ICAD 组患者更易为男性（85.71% vs. 67.86%，p=0.012）。高血压、糖尿病、吸烟、饮酒和颈部外伤在 ICAD 与 VAD 之间的发生率无差异。ICAD 夹层更常见于动脉的颅外段，而 VAD 夹层更常见于颅内段（70.24% vs. 44.64%，p=0.003）。相反，VAD 夹层更常见于颅内动脉（55.36% vs. 29.76%，p=0.003）。影像学上，ICAD 中双腔征（36.90% vs. 19.64%，p=0.029）和内膜瓣（11.90% vs. 1.79%，p=0.029）更为常见，夹层动脉瘤较少见（13.10% vs. 26.79%，p=0.041）。
ICAD 和 VAD 患者的颈内动脉和颅内动脉夹层分布不同，影像学特征的检出频率也不同。
