Lesion localization, etiology and demographic evaluation in spontaneous cerebral and cervical arteries dissection

INTRODUCTION[|]Spontaneous carotid and vertebral artery dissection involves 1-2% of all ischemic stroke and 10-25% of stroke cases among young adults. The aim of our study was to identify the dissection cases and neurological symptoms and signs, to investigate the etiological risk factors, to reveal the vascular involvement and to evaluate the demographic characteristics and treatment practices particularly in young patients. [¤]METHODS[|]A total of 53 cranio-cervical dissection patients who were hospitalized in our hospital between January 2010 - July 2019 were examined retrospectively. Age, sex, risk factors, and trauma history in the last month, neurological symptoms and signs were noted. Cranial MRI, cranial and cervical MR-anjio, T1-weighed fat sat cervical MRI, DSA were applied for suspected patients. [¤]RESULTS[|]Of the 53 patients with dissection, 23 were female and 30 were male. The mean age for vertebral artery dissection (VAD) was 40,8 and carotis artery dissection (CAD) was 42,2 years. Thirty patients were VAD, 23 patients were CAD. Four patients had bilateral carotid and one patient had bilateral vertebral artery dissection. In the subgroup analysis, 30 patients had extracranial, 23 had intracranial dissection. When risk factors were evaluated, cigarette smoking and hypertension were most common. Major or minor trauma story was observed in 41,5% of patients. Antiaggregant treatment was used in 88,6% of patients. [¤]DISCUSSION AND CONCLUSION[|]In the present study, VAD was more common and can be different from the other studies in literature. Extracranial dissections were dominant and nearly 40% of all dissections had a history of minor or major trauma. Smoking and hypertension were the most common risk factors. It needs more patients with multi center study to understand the incidence of craniocervical dissections in Turkish population. Arterial dissection has to be considered in differential diagnosis in young stroke patients. [¤]