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Comparison of spontaneous intracranial vertebral artery dissection with large artery disease.

Lee, JS; Yong, SW; Bang, OY; Shin, YS; Kim, BM; Kim, SY
Archives of neurology, 63(12):1738-1744, 2006
Journal Title
Archives of neurology
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.
MeSH terms
AgedAtherosclerosis/pathologyCerebral AngiographyDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMagnetic Resonance AngiographyMaleMiddle AgedRetrospective StudiesRisk FactorsStroke/epidemiologyStroke/etiologyStroke/pathologyTomography, X-Ray ComputedVertebral Artery Dissection/complicationsVertebral Artery Dissection/epidemiology*Vertebral Artery Dissection/pathology*Vertebrobasilar Insufficiency/complicationsVertebrobasilar Insufficiency/epidemiology*Vertebrobasilar Insufficiency/pathology*
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
AJOU Authors
신, 용삼김, 선용
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