1. Neurology
- Author
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Compter, Annette, Schilling, Sabrina, Vaineau, Cloé Juliette, Goeggel-Simonetti, Barbara, Metso, Tiina M., Southerland, Andrew, Pezzini, Alessandro, Kloss, Manja, Touzé, Emmanuel, Worrall, Bradford B., Thijs, Vincent, Bejot, Yannick, Reiner, Peggy, Grond-Ginsbach, Caspar, Bersano, Anna, Brandt, Tobias, Caso, Valeria, Lyrer, Philippe A., Traenka, Christopher, Lichy, Christoph, Martin, Juan José, Leys, Didier, Sarikaya, Hakan, Baumgartner, Ralph W., Jung, Simon, Fischer, Urs, Engelter, Stefan T., Dallongeville, Jean, Chabriat, Hugues, Tatlisumak, Turgut, Bousser, Marie-Germaine, Arnold, Marcel, Debette, Stéphanie, in CADIPS-Group, C. Ferrarese Collaborators (51): Abboud S, Pandolfo M, Bodenant M, Louillet F, Mas JL, Leder S, Léger A, Deltour S, Crozier S, Méresse I, Canaple S, Godefroy O, Giroud M, Decavel P, Medeiros E, Montiel P, Moulin T, Vuillier F, Amouyel P, Metso AJ, Werner I, Arnold ML, Santos MD, Dichgans M, Thomas-Feles C, Weber R, De Giuli V, Caria F, Poli L, Padovani A, Lanfranconi S, Beretta S, Ferrarese C, Giacolone G, Paolucci S, Fluri F, Hatz F, Gisler D, Bonati L, Gensicke H, Amort M, Altintas A, Markus H, Majersik J, Cole J, Kittner S, Buffon F, Heldner MR, Mattle HP, Kurmann R, Gralla J., Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Compter, A, Schilling, S, Vaineau, C, Goeggel-Simonetti, B, Metso, T, Southerland, A, Pezzini, A, Kloss, M, Touzé, E, Worrall, B, Thijs, V, Bejot, Y, Reiner, P, Grond-Ginsbach, C, Bersano, A, Brandt, T, Caso, V, Lyrer, P, Traenka, C, Lichy, C, Martin, J, Leys, D, Sarikaya, H, Baumgartner, R, Jung, S, Fischer, U, Engelter, S, Dallongeville, J, Chabriat, H, Tatlisumak, T, Bousser, M, Arnold, M, Debette, S, In, C, C., F, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Leder, S, Léger, A, Deltour, S, Crozier, S, Méresse, I, Canaple, S, Godefroy, O, Giroud, M, Decavel, P, Medeiros, E, Montiel, P, Moulin, T, Vuillier, F, Amouyel, P, Metso, A, Werner, I, Santos, M, Dichgans, M, Thomas-Feles, C, Weber, R, De Giuli, V, Caria, F, Poli, L, Padovani, A, Lanfranconi, S, Beretta, S, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Bonati, L, Gensicke, H, Amort, M, Altintas, A, Markus, H, Majersik, J, Cole, J, Kittner, S, Buffon, F, Heldner, M, Mattle, H, Kurmann, R, and Gralla, J
- Subjects
Adult ,Male ,medicine.medical_specialty ,Subarachnoid hemorrhage ,Vertebral artery dissection ,International Cooperation ,030204 cardiovascular system & hematology ,Ribosomal Protein S6 Kinases, 90-kDa ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Risk Factors ,Internal medicine ,Outcome Assessment, Health Care ,medicine ,Humans ,Thrombolytic Therapy ,Family history ,Stroke ,Vertebral Artery Dissection ,business.industry ,Hazard ratio ,Odds ratio ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,3. Good health ,Logistic Models ,Treatment Outcome ,VINTAGE ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Neurology (clinical) ,business ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery ,Fibrinolytic agent ,Cohort study - Abstract
ObjectiveTo assess putative risk factors and outcome of multiple and early recurrent cervical artery dissection (CeAD).MethodsWe combined data from 2 multicenter cohorts and compared patients with multiple CeAD at initial diagnosis, early recurrent CeAD within 3 to 6 months, and single nonrecurrent CeAD. Putative risk factors, clinical characteristics, functional outcome, and risk of recurrent ischemic events were assessed.ResultsOf 1,958 patients with CeAD (mean ± SD age 44.3 ± 10 years, 43.9% women), 1,588 (81.1%) had single nonrecurrent CeAD, 340 (17.4%) had multiple CeAD, and 30 (1.5%) presented with single CeAD at admission and had early recurrent CeAD. Patients with multiple or early recurrent CeAD did not significantly differ with respect to putative risk factors, clinical presentation, and outcome. In multivariable analyses, patients with multiple or early recurrent CeAD more often had recent infection (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.29–2.53), vertebral artery dissection (OR 1.82, 95% CI 1.34–2.46), family history of stroke (OR 1.55, 95% CI 1.06–2.25), cervical pain (OR 1.36, 95% CI 1.01–1.84), and subarachnoid hemorrhage (OR 2.85, 95% CI 1.01–8.04) at initial presentation compared to patients with single nonrecurrent CeAD. Patients with multiple or early recurrent CeAD also had a higher incidence of cerebral ischemia (hazard ratio 2.77, 95% CI 1.49–5.14) at 3 to 6 months but no difference in functional outcome compared to patients with single nonrecurrent CeAD.ConclusionPatients with multiple and early recurrent CeAD share similar risk factors, clinical characteristics, and functional outcome. Compared to patients with single nonrecurrent CeAD, they are more likely to have recurrent cerebral ischemia at 3 to 6 months, possibly reflecting an underlying transient vasculopathy.
- Published
- 2018