Spontaneous Cervicocerebral Arterial Dissections

Abstract

Background: Spontaneous cervicocerebral arterial dissections account for 10 to 25 percent of ischemic strokes in the young and middle-aged adults. To recognize clinical varieties of presentation and early diagnosis are very important. Anticoagulation therapy can be started promptly, thereby minimizing the risks of infarction, permanent neurologicdisability, and death. Objective: The aim of this study was ta explore the variety of clinical presentation and to find the factors affecting prognosis of cases with spontaneous cervicocerebral artery dissection by determining risk factors, warning signs, early symptoms, neurological findings and dissection sites. Method: In this study 9 patients, who had no major trauma history, with spontaneous dissections, all confirmed by conventionel anjiography were evaluated retrospectively. Results: The mean age was 35.3 (26-50). Eight patients had risk factors and warning signs. Early symptoms were either transient ischemic attacks ar ischemic findings of clinical presentation. Total 11 dissections were determined. Two patients had total dissections and the others had extracranial segment dissections. Four patients showed good clinical improvement, five had neurological sequela. Conclusion: As a result, we found that patients with neurological sequale generally had worse early symptoms (loss of conciousness) or more quickly developing ischemic features (within 30 minutes) and also prognosis was affected by totally dissection or simultaneous bilateral dissection.