Abstract
Background and objectiveCervicocephalic arterial dissection can cause both ischemic stroke and hemorrhagic stroke. However, spontaneous cervicocephalic arterial dissection presenting only with headache and neck pain has rarely been reported. The clinical features of patients with spontaneous cervicocephalic arterial dissection presenting only with headache and neck pain were investigated.MethodsThe subjects were seven patients with spontaneous cervicocephalic arterial dissection with headache and neck pain alone who were admitted to our hospital during the past 3 years. The clinical features of these patients were investigated. The diagnosis of arterial dissection was based on the criteria of the Strategies Against Stroke Study for Young Adults in Japan.ResultsThe age of the patients (3 males, 4 females) ranged from 35 to 79 (mean, 51.0 ± 16.2) years. Six patients had vertebral artery dissection, one had internal carotid artery dissection, and one had an association of vertebral and internal carotid artery dissection. With the exception of one patient, the headache and neck pain were unilateral. All patients with vertebral artery dissection complained of posterior cervical or occipital pain. In the cases of internal carotid artery dissection, one patient complained of temporal pain, and one patient with co-existing vertebral artery dissection complained of posterior cervical pain. The mode of onset was acute in five patients, thunderclap in one, and gradual and progressive in one. The pain was severe in all cases. Five patients complained of continuous pain, while two had intermittent pain. The quality of the pain was described as throbbing by five patients and constrictive by two. The headache and neck pain persisted for 1 week or longer in six of the seven patients.ConclusionCervicocephalic arterial dissection should be suspected when patients complain of intense unilateral posterior cervical and occipital pain or temporal pain.
Highlights
Background and objectiveCervicocephalic arterial dissection can cause both ischemic stroke and hemorrhagic stroke
In the cases of internal carotid artery dissection, one patient complained of temporal pain, and one patient with co-existing vertebral artery dissection complained of posterior cervical pain
Spontaneous cervicocephalic arterial dissection is an important cause of stroke
Summary
The subjects were seven patients with spontaneous cervicocephalic arterial dissection with headache and neck pain alone who were admitted to our hospital during the past 3 years. Between April 2007 and March 2010, 61 patients with spontaneous cervicocephalic arterial dissection (vertebral artery in 41 cases, internal carotid artery in 10 cases, middle cerebral artery in 4 cases, anterior cerebral artery in 3 cases, basilar artery in 3 cases, and posterior cerebral artery in 1 case) were admitted to our stroke center. Of these 61 patients, the clinical presentations were cerebral ischemia in 35 cases, subarachnoid hemorrhage in 13 cases, headache and neck pain only in 7 cases, and asymptomatic in 6 cases. Diabetes mellitus was defined as blood sugar elevation (either fasting C126 mg/dL, 75 g OGTT C200 mg/dL, or random C200 mg/dL) and HbA1c (international standard) C6.5%; hypertension was defined as taking an antihypertensive agent or having blood pressure C140/90 mmHg; and hypercholesterolemia was defined as taking a hypolipidemic agent or having total cholesterol C220 mg/dL or LDL cholesterol C140 mg/dL
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
