Vertebrobasilar dissections: case series comparing patients with and without dissecting aneurysms

Badve, Monica S., Henderson, Robert D., O'Sullivan, John D., Wong, Andrew A., Mitchell, Ken, Coulthard, Alan and Read, Stephen J. (2014) Vertebrobasilar dissections: case series comparing patients with and without dissecting aneurysms. Journal of Clinical Neuroscience, 21 11: 2028-2030. doi:10.1016/j.jocn.2014.02.015

Author Badve, Monica S.
Henderson, Robert D.
O'Sullivan, John D.
Wong, Andrew A.
Mitchell, Ken
Coulthard, Alan
Read, Stephen J.
Title Vertebrobasilar dissections: case series comparing patients with and without dissecting aneurysms
Journal name Journal of Clinical Neuroscience   Check publisher's open access policy
ISSN 0967-5868
Publication date 2014-11
Year available 2014
Sub-type Letter to editor, brief commentary or brief communication
DOI 10.1016/j.jocn.2014.02.015
Open Access Status
Volume 21
Issue 11
Start page 2028
End page 2030
Total pages 3
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Abstract Vertebrobasilar dissections are being increasingly diagnosed due to better awareness and increased availability of modern imaging techniques of the intracranial and extracranial arteries. The clinical presentation and outcome in patients with vertebrobasilar dissections may be complicated by dissecting aneurysms. The aim of this retrospective study was to compare the clinical profile of patients with vertebrobasilar dissections with and without dissecting aneurysms, and to determine predisposing factors to the development of aneurysms. Thirty patients (19 [63%] male; median age 44.5 years) were identified. The patients were divided into two groups, an aneurysmal dissection group with seven patients and a non-aneurysmal dissection group with 23 patients. Eight (27%) patients presented with dissection after trivial trauma, three (10%) following high-speed vehicular trauma, two (7%) were associated with infection, but most (57%) were apparently spontaneous. Migraine with aura (p = 0.008) and female sex (p = 0.03) were observed more frequently in the aneurysmal dissection group. Though vascular risk factors other than hypertension and atrial fibrillation were seen in a greater percentage of patients in the non-aneurysmal dissection group, this was not statistically significant. Patients were treated with antiplatelet agents (n = 8) or warfarin (n = 13) or underwent an endovascular intervention (n = 6). Post-discharge data were available in 19 patients, of whom 14 (74%) were independent at a median follow-up of 4 months. Female sex and migraine with aura may predispose to the formation of acute dissecting aneurysms and this requires further research. Larger, prospective studies are required to ascertain epidemiologic and etiologic factors predisposing patients to the development of both intracranial and extracranial dissecting aneurysms in the vertebrobasilar circulation.
Keyword Dissecting aneurysm
Vascular risk factors
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Letter to editor, brief commentary or brief communication
Collections: UQ Centre for Clinical Research Publications
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