Clinical analysis of cerebral artery dissection

Abstract

Objective To investigate the clinical features, recanalization after medical treatment and clinical outcome of cerebral artery dissection. Methods We reviewed the clinical records of ischemic stroke patients with cerebral artery dissection who visited the First Affiliated Hospital of Zhejiang University between October 2010 and December 2013.We recorded patients' general information, neurological deficit, imaging and clinical treatment. We followed up the patients and statistically analyzed demographic data, recanalization and clinical outcome. Results Among 28 cases of cerebral artery dissection, carotid dissection was the most common (n=19, 67.9%), followed by vertebral artery dissection (n=7, 25.0%), while the combination of carotid and vertebral artery dissection was rare (n=2, 7.1%). In the imaging of cerebral artery dissection, wire beads and occlusion were the most common signs (n=15, 53.6%), followed by rat tail sign (n=7, 25.0%), aneurysmal dilatation (n=4, 14.3%) and dual-chamber levy (n=2, 7.1%). There were 18 cases of acute cerebral infarction in the 28 studied cases, but there was no significant difference between the degree of stenosis and cerebral infarction caused by cerebral artery dissection. All patients received standard antithrombotic therapy. The difference of the recanalization rate between using anti-platelet aggregation and anticoagulant therapy was not statistically significant (5/6 vs 9/13, P=0.37). Conclusions Although cerebral artery dissection is relatively rare clinically, the typical clinical manifestations of the disease and the characteristic imaging are helpful for the diagnosis. Standardization of antithrombotic treatment is still the first-line treatment of cerebral artery dissection. Key words: Intracranial aneurysm; Aneurysm, dissecting; Platelet aggregation; Anticoagulants