Significance of headache in intracranial vertebrobasilar artery dissections: an observational study
Abstract Headache may represent acute phase of intracranial vertebrobasilar artery dissection (iVBAD). We aimed to evaluate its clinical significance in iVBAD. Consecutive acute iVBAD patients were grouped into ruptured iVBAD, unruptured iVBAD with no headache, isolated headache, or concurrent heada...
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| Format: | Article |
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Nature Portfolio
2023-12-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-48941-5 |
| _version_ | 1797398014982094848 |
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| author | Seong-Joon Lee Jin Soo Lee Min Kim So Young Park Woo Sang Jung Jin Wook Choi Yong Cheol Lim Ji Man Hong |
| author_facet | Seong-Joon Lee Jin Soo Lee Min Kim So Young Park Woo Sang Jung Jin Wook Choi Yong Cheol Lim Ji Man Hong |
| author_sort | Seong-Joon Lee |
| collection | DOAJ |
| description | Abstract Headache may represent acute phase of intracranial vertebrobasilar artery dissection (iVBAD). We aimed to evaluate its clinical significance in iVBAD. Consecutive acute iVBAD patients were grouped into ruptured iVBAD, unruptured iVBAD with no headache, isolated headache, or concurrent headache with neurological symptoms. Composite hemorrhagic/ischemic endpoints, and dynamic arterial changes were graded. Clinical characteristics of the four groups, and association between headache and composite outcomes was evaluated. Headaches were precedent in 79% of the ruptured iVBAD patients (maximal delay, 10D). In unruptured iVBAD, when patients with no headache (N = 69), concurrent headache (N = 111), and isolated headache (N = 126) were compared, concurrent headache was associated with ischemic endpoints (isolated headache as reference, adjusted odds ratio: 6.40, 95% confidence interval [2.03–20.19]). While there were no differences in hemorrhagic endpoints, dynamic arterial changes were higher in the isolated headache group (aOR: 3.98, 95% CI [1.72–9.18]) but not for the concurrent headache group (aOR: 1.59 [0.75–3.38]) compared to no headache group. Headache was more commonly severe (48.4% vs. 17.3%, p < 0.001) and ipsilateral (59.7% vs. 45.5%, p = 0.03) for isolated headache compared to concurrent headache, indicating a higher causal relationship. In iVBAD, isolated headache may be considered an acute-phase biomarker, associated with dynamic arterial changes. |
| first_indexed | 2024-03-09T01:18:37Z |
| format | Article |
| id | doaj.art-728ca1fe71fb4b2ba6c88cf98de30984 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T01:18:37Z |
| publishDate | 2023-12-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-728ca1fe71fb4b2ba6c88cf98de309842023-12-10T12:16:52ZengNature PortfolioScientific Reports2045-23222023-12-011311910.1038/s41598-023-48941-5Significance of headache in intracranial vertebrobasilar artery dissections: an observational studySeong-Joon Lee0Jin Soo Lee1Min Kim2So Young Park3Woo Sang Jung4Jin Wook Choi5Yong Cheol Lim6Ji Man Hong7Department of Neurology, Ajou University School of MedicineDepartment of Neurology, Ajou University School of MedicineDepartment of Neurology, Ajou University School of MedicineDepartment of Neurology, Ajou University School of MedicineDepartment of Radiology, Ajou University School of MedicineDepartment of Radiology, Ajou University School of MedicineDepartment of Neurosurgery, Ajou University School of MedicineDepartment of Neurology, Ajou University School of MedicineAbstract Headache may represent acute phase of intracranial vertebrobasilar artery dissection (iVBAD). We aimed to evaluate its clinical significance in iVBAD. Consecutive acute iVBAD patients were grouped into ruptured iVBAD, unruptured iVBAD with no headache, isolated headache, or concurrent headache with neurological symptoms. Composite hemorrhagic/ischemic endpoints, and dynamic arterial changes were graded. Clinical characteristics of the four groups, and association between headache and composite outcomes was evaluated. Headaches were precedent in 79% of the ruptured iVBAD patients (maximal delay, 10D). In unruptured iVBAD, when patients with no headache (N = 69), concurrent headache (N = 111), and isolated headache (N = 126) were compared, concurrent headache was associated with ischemic endpoints (isolated headache as reference, adjusted odds ratio: 6.40, 95% confidence interval [2.03–20.19]). While there were no differences in hemorrhagic endpoints, dynamic arterial changes were higher in the isolated headache group (aOR: 3.98, 95% CI [1.72–9.18]) but not for the concurrent headache group (aOR: 1.59 [0.75–3.38]) compared to no headache group. Headache was more commonly severe (48.4% vs. 17.3%, p < 0.001) and ipsilateral (59.7% vs. 45.5%, p = 0.03) for isolated headache compared to concurrent headache, indicating a higher causal relationship. In iVBAD, isolated headache may be considered an acute-phase biomarker, associated with dynamic arterial changes.https://doi.org/10.1038/s41598-023-48941-5 |
| spellingShingle | Seong-Joon Lee Jin Soo Lee Min Kim So Young Park Woo Sang Jung Jin Wook Choi Yong Cheol Lim Ji Man Hong Significance of headache in intracranial vertebrobasilar artery dissections: an observational study Scientific Reports |
| title | Significance of headache in intracranial vertebrobasilar artery dissections: an observational study |
| title_full | Significance of headache in intracranial vertebrobasilar artery dissections: an observational study |
| title_fullStr | Significance of headache in intracranial vertebrobasilar artery dissections: an observational study |
| title_full_unstemmed | Significance of headache in intracranial vertebrobasilar artery dissections: an observational study |
| title_short | Significance of headache in intracranial vertebrobasilar artery dissections: an observational study |
| title_sort | significance of headache in intracranial vertebrobasilar artery dissections an observational study |
| url | https://doi.org/10.1038/s41598-023-48941-5 |
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