Abstract
Few data exist on long-term outcome of patients with cervical aneurysm due to spontaneous dissection of the internal carotid artery (sICAD).1,2 In this prospective observational study, we assessed the long-term risk of stroke, rupture, and development of local symptoms or signs on the side of dissection (headache, neck pain, Horner syndrome, cranial nerve palsy) in cervical aneurysms caused by sICAD. We included 279 consecutive patients with sICAD (diagnosed as previously reported)3 who underwent cerebral MR angiography (MRA; n = 195), digital subtraction angiography (DSA, n = 72), or both (n = 12) at two academic centers from January 1987 until March 2005. Five of these patients died from stroke within 2 weeks after symptom onset; an ICA aneurysm was diagnosed in one of them. A second angiogram (MRA, n = 218; DSA, n = 17; CT angiography, n = 6) was done in 236 (86%) of 274 survivors. Two neurologists blinded to the patients' identity reviewed the angiographies and characterized the aneurysms (localization: postbifurcation, midcervical, or subpetrous third …
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