101. Cervical artery dissection in patients ≥60 years: Often painless, few mechanical triggers
- Author
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Traenka, C, Dougoud, D, Simonetti, B, Metso, T, Debette, S, Pezzini, A, Kloss, M, Grond Ginsbach, C, Majersik, J, Worrall, B, Leys, D, Baumgartner, R, Caso, V, Béjot, Y, Compter, A, Reiner, P, Thijs, V, Southerland, A, Bersano, A, Brandt, T, Gensicke, H, Touzé, E, Martin, J, Chabriat, H, Tatlisumak, T, Lyrer, P, Arnold, M, Engelter, ST, 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, Wiest T, Werner I, Arnold ML, Santos MD, Dichgans M, Thomas Feles C, Weber R, Del Zotto E, Giossi A, Volonghi I, Padovani A, Poli L, Morotti A, Lanfranconi S, Baron P, Beretta S, Giacolone G, Fluri F, Hatz F, Gisler D, Bonati, Amort M, Markus H, Meschia JF, Cole J, Kittner S, Buffon F, Mawet J, Heldner MR, Mattle HP, Gralla J., FERRARESE, CARLO, Neurologian yksikkö, Clinicum, Department of Neurosciences, HUS Neurocenter, Traenka, C, Dougoud, D, Simonetti, B, Metso, T, Debette, S, Pezzini, A, Kloss, M, Grond Ginsbach, C, Majersik, J, Worrall, B, Leys, D, Baumgartner, R, Caso, V, Béjot, Y, Compter, A, Reiner, P, Thijs, V, Southerland, A, Bersano, A, Brandt, T, Gensicke, H, Touzé, E, Martin, J, Chabriat, H, Tatlisumak, T, Lyrer, P, Arnold, M, Engelter, S, Abboud, S, 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, Wiest, T, Werner, I, Santos, M, Dichgans, M, Thomas Feles, C, Weber, R, Del Zotto, E, Giossi, A, Volonghi, I, Padovani, A, Poli, L, Morotti, A, Lanfranconi, S, Baron, P, Beretta, S, Ferrarese, C, Giacolone, G, Fluri, F, Hatz, F, Gisler, D, Bonati, Amort, M, Markus, H, Meschia, J, Cole, J, Kittner, S, Buffon, F, Mawet, J, Heldner, M, Mattle, H, and Gralla, J
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Adult ,Male ,medicine.medical_specialty ,Vertebral artery dissection ,FEATURES ,030204 cardiovascular system & hematology ,3124 Neurology and psychiatry ,Brain Ischemia ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Modified Rankin Scale ,Internal medicine ,YOUNG-ADULTS ,CADISP ,Odds Ratio ,medicine ,Humans ,Risk factor ,Young adult ,610 Medicine & health ,Stroke ,VASCULAR RISK-FACTORS ,Aged ,Vertebral Artery Dissection ,Neck pain ,Neck Pain ,business.industry ,Age Factors ,Middle Aged ,medicine.disease ,BRAIN-SUPPLYING ARTERIES ,3. Good health ,Surgery ,PREVALENCE ,MIGRAINE ,VERTEBRAL ARTERY ,Cohort ,Female ,Neurology (clinical) ,medicine.symptom ,business ,CAROTID-ARTERY ,030217 neurology & neurosurgery ,ISCHEMIC-STROKE PATIENTS ,Cohort study - Abstract
Objective:In a cohort of patients diagnosed with cervical artery dissection (CeAD), to determine the proportion of patients aged ≥60 years and compare the frequency of characteristics (presenting symptoms, risk factors, and outcome) in patients aged Methods:We combined data from 3 large cohorts of consecutive patients diagnosed with CeAD (i.e., Cervical Artery Dissection and Ischemic Stroke Patients–Plus consortium). We dichotomized cases into 2 groups, age ≥60 and Results:Among 2,391 patients diagnosed with CeAD, we identified 177 patients (7.4%) aged ≥60 years. In this age group, cervical pain (ORadjusted 0.47 [0.33–0.66]), headache (ORadjusted 0.58 [0.42–0.79]), mechanical trigger events (ORadjusted 0.53 [0.36–0.77]), and migraine (ORadjusted 0.58 [0.39–0.85]) were less frequent than in younger patients. In turn, hypercholesterolemia (ORadjusted 1.52 [1.1–2.10]) and hypertension (ORadjusted 3.08 [2.25–4.22]) were more frequent in older patients. Key differences between age groups were confirmed in secondary analyses. In multivariable, adjusted analyses, favorable outcome (i.e., modified Rankin Scale score 0–2) was less frequent in the older age group (ORadjusted 0.45 [0.25, 0.83]).Conclusion:In our study population of patients diagnosed with CeAD, 1 in 14 was aged ≥60 years. In these patients, pain and mechanical triggers might be missing, rendering the diagnosis more challenging and increasing the risk of missed CeAD diagnosis in older patients.
- Published
- 2017
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