TY - JOUR
T1 - Traumatic and Spontaneous Vertebral Artery Dissections
T2 - An Analysis of Tertiary-Center 310 Patient Cohort
AU - Prasad, Nikil
AU - Mitra, Akash
AU - Shlobin, Nathan A.
AU - Azad, Hooman A.
AU - Cloney, Michael B.
AU - Hopkins, Benjamin S.
AU - Jahromi, Babak S.
AU - Potts, Matthew B.
AU - Dahdaleh, Nader S.
N1 - Publisher Copyright:
© 2021 Congress of Neurological Surgeons 2021.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - BACKGROUND: Vertebral artery dissections (VADs) are rare yet potentially devastating events. While the etiology of these events is either traumatic or spontaneous, there is a paucity of quantitative literature comparing the two. OBJECTIVE: To identify differences in predisposing factors, event characteristics, and clinical outcomes between traumatic VADs (tVADs) and spontaneous VADs (sVADs). METHODS: We retrospectively identified patients with VADs presenting to our institution at VAD onset with at least a 3-mo follow-up. Demographics, event characteristics, treatment details, and neurological outcomes as modified Rankin scale (mRS) scores were collected. RESULTS: Of the 310 patients sustaining 366 VADs total, 187 (60.3%) patients experienced a total of 221 (60.4%) sVADs and 123 (39.7%) patients experienced a total of 145 (39.6%) tVADs. sVADs were more likely to occur in the intracranial course of the artery (P =. 042) and have a lower mRS at discharge, 3-month, and last clinical follow-up (P = 003,. 002, and. 001, respectively). tVADs were more likely associated with concomitant fractures (P <. 001). CONCLUSION: Despite similar patient populations, tVADs are associated with higher mRS scores at all time points. Although further study is needed, this may suggest other concomitant trauma rather than the VAD itself is contributing to worse neurological status in patients with tVADs.
AB - BACKGROUND: Vertebral artery dissections (VADs) are rare yet potentially devastating events. While the etiology of these events is either traumatic or spontaneous, there is a paucity of quantitative literature comparing the two. OBJECTIVE: To identify differences in predisposing factors, event characteristics, and clinical outcomes between traumatic VADs (tVADs) and spontaneous VADs (sVADs). METHODS: We retrospectively identified patients with VADs presenting to our institution at VAD onset with at least a 3-mo follow-up. Demographics, event characteristics, treatment details, and neurological outcomes as modified Rankin scale (mRS) scores were collected. RESULTS: Of the 310 patients sustaining 366 VADs total, 187 (60.3%) patients experienced a total of 221 (60.4%) sVADs and 123 (39.7%) patients experienced a total of 145 (39.6%) tVADs. sVADs were more likely to occur in the intracranial course of the artery (P =. 042) and have a lower mRS at discharge, 3-month, and last clinical follow-up (P = 003,. 002, and. 001, respectively). tVADs were more likely associated with concomitant fractures (P <. 001). CONCLUSION: Despite similar patient populations, tVADs are associated with higher mRS scores at all time points. Although further study is needed, this may suggest other concomitant trauma rather than the VAD itself is contributing to worse neurological status in patients with tVADs.
KW - Cervical artery dissection
KW - Spontaneous vertebral artery dissection
KW - Traumatic vertebral artery dissection
KW - Vertebral artery dissection
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U2 - 10.1093/ons/opab277
DO - 10.1093/ons/opab277
M3 - Article
C2 - 34392360
AN - SCOPUS:85118598134
SN - 2332-4252
VL - 21
SP - 343
EP - 350
JO - Operative Neurosurgery
JF - Operative Neurosurgery
IS - 5
ER -