Cervicocranial Arterial Dissection: An Analysis of the Clinical Features, Prognosis, and Treatment Efficacy

Title:Cervicocranial Arterial Dissection: An Analysis of the Clinical Features, Prognosis, and Treatment Efficacy

Volume: 10 Issue: 2

Author(s): Jiali Jin, Jingjing Guan, Lai Qian, Mei-Juan Zhang, Yujie Huang, Yongbo Yang, Dening Guan, Hui Zhao, Yongjuan Lin, Zhibin Chen, Weiyun Zhang, Jingwei Li and Yun Xu

Affiliation:

Keywords: cervicocranial arterial dissection, clinical features, conservative treatment, dissecting aneurysm, endovascular treatment, prognosis, vertebrobasilar artery

Abstract: Clinical features and therapeutic strategies of cervicocranial arterial dissection (CCAD) are still unclear. A retrospective review was conducted on 71 CCAD patients. Diagnosed by DSA and outcome evaluation was through mRS scores follow-up 12 months. All patients were allocated into three groups according to clinical situation: 1) subarachnoid hemorrhage (SAH), 2) ischemic symptoms and 3) mass effect. CCAD with anterior circulation arterial dissection (ACAD) had higher ischemia than that with posterior circulation arterial dissection (PCAD) (p=0.023). The non-aneurysmal dissection (NAD) patients were susceptible to ischemia (p=0.00) and patients with aneurismal dissection (AD) were more susceptible to SAH (p=0.001); The outcome of patients with SAH was significantly worse than patients with other manifestations (p=0.012). Following up one year, the outcome of CCAD involving posterior inferior cerebellar artery (PICA) was significantly worse than the other area (p=0.035). There was no statistically significant difference in mRS scores between endovascular treatment and conservative treatment (p=0.052) at one year follow-up. Patients suffering from SAH that received endovascular treatment experienced improved outcomes than patients with conservative treatment (p=0.033). The patients in the ACAD, NAD and extracranial CCAD groups were more likely to suffer from ischemia, while patients in the AD group were susceptible to SAH. CCAD with SAH or involving PICA had poor prognoses. The therapeutic efficacy of conservative treatment is nearly equal to endovascular treatment in CCAD patients follow up 12 months; however, endovascular treatment may decrease the risk of mortality for the patient with SAH.

Cite this article as:

Jin Jiali, Guan Jingjing, Qian Lai, Zhang Mei-Juan, Huang Yujie, Yang Yongbo, Guan Dening, Zhao Hui, Lin Yongjuan, Chen Zhibin, Zhang Weiyun, Li Jingwei and Xu Yun, Cervicocranial Arterial Dissection: An Analysis of the Clinical Features, Prognosis, and Treatment Efficacy, Current Neurovascular Research 2013; 10 (2) . https://dx.doi.org/10.2174/1567202611310020008