• Akash Mitra, Nathan A Shlobin, Hooman A Azad, Nikil Prasad, Matthew B Potts, and Nader S Dahdaleh.
• Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
• World Neurosurg. 2021 May 1; 149: e1128-e1133.

BackgroundVertebral artery dissections (VADs) are a rare cause of ischemic stroke that can occasionally lead to intracranial hemorrhage (ICH). This study aims to identify differences in predisposing factors, event characteristics, and outcomes between patients with only a VAD and patients with VAD and concomitant ICH.MethodsWe conducted a retrospective chart review of 301 patients who presented with VADs at our institution from 2004-2018. A total of 13 patients were identified with VAD and concomitant ICH. Data were collected on demographics, event characteristics, treatments, and neurologic outcomes, measured using the modified Rankin Scale (mRS).ResultsVAD+ICH and VAD-only groups were similar in terms of age, sex, and recorded comorbidities. Additionally, etiology of the dissections did not seem to vary between groups (P = 0.6), even when selecting for traumatic causes such as motor vehicle accidents (P = 0.22) and violence (P = 0.25). Concomitant strokes and aneurysms/pseudoaneurysms occurred in similar proportions as well, but cervical fractures were more common in the VAD+ICH group (P = 0.003). Using the mRS as a measure of neurological outcome, we found that the VAD+ICH group had worse neurologic function at discharge, 3-month follow-up, and last follow-up (P < 0.001).ConclusionsPatients who experienced an ICH in addition to a VAD did not have any identifiable risk factors. Cervical spine fractures were more common in patients with VAD and ICH. VAD patients with a concomitant ICH have worse neurologic outcomes than patients with only a VAD.Copyright © 2021 Elsevier Inc. All rights reserved.

35 keywords...

hide…