Internal carotid and vertebral artery dissection: an approach to patient management
We aimed to evaluate the treatment results in patients with internal carotid artery (ICA) and vertebral artery (VA) dissection. Materials and methods. We examined 285 patients (122 men and 163 women, mean age 37.7 8.1 years) with ICA dissection (n = 147), VA dissection (n = 122), or a combinatio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Research Center of Neurology
2021-03-01
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| Series: | Анналы клинической и экспериментальной неврологии |
| Subjects: | |
| Online Access: | https://annaly-nevrologii.com/journal/pathID/article/viewFile/720/561 |
| _version_ | 1811337918277484544 |
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| author | Lyudmila A. Kalashnikova Larisa A. Dobrynina Marina Yu Maksimova Marine M. Tanashyan Maria S. Danilova Marina V. Dreval |
| author_facet | Lyudmila A. Kalashnikova Larisa A. Dobrynina Marina Yu Maksimova Marine M. Tanashyan Maria S. Danilova Marina V. Dreval |
| author_sort | Lyudmila A. Kalashnikova |
| collection | DOAJ |
| description | We aimed to evaluate the treatment results in patients with internal carotid artery (ICA) and vertebral artery (VA) dissection.
Materials and methods. We examined 285 patients (122 men and 163 women, mean age 37.7 8.1 years) with ICA dissection (n = 147), VA dissection (n = 122), or a combination of both (n = 16). The dissection presented as ischemic stroke in 175 patients and with local symptoms in the others. Out of 173 patients, 156 were managed conservatively. Efficacy of the conservative treatment in first 3 months was assessed in 143 patients who received anticoagulants (AC; n = 38), antiplatelets (AP; n = 42), both (n = 45) or no antithrombotic therapy (n = 18).
Results. Good functional recovery (02 points on the modified Rankin Scale) after 3 months was noted in 70% of patients, with no statistically significant differences between the different treatment types. There were 3 (2%) deaths in patients with severe stroke receiving AC. Recurrent ischemic stroke occurred in 10% of patients most often (86%) occurring in the first 3 weeks and triggered by head movement, straining, or fluctuating blood pressure. No statistically significant differences were found between different conservative treatments. However, there was a tendency towards increased frequency of recurrent stroke in patients without antithrombotic therapy (22%), as compared with patients receiving AC (4%) or AP (12%). There were no strokes in 110 patients with local symptoms due to ICA/VA dissection during the observation period.
Conclusion. There were no statistically significant differences in AC and AP efficacy in patients with ICA or VA dissection. A neck brace to prevent head movement and control of blood pressure are advisable alongside pharmacological therapy. |
| first_indexed | 2024-04-13T18:03:00Z |
| format | Article |
| id | doaj.art-d385367ea39a4f6b8e2b22c055847c02 |
| institution | Directory Open Access Journal |
| issn | 2075-5473 2409-2533 |
| language | English |
| last_indexed | 2024-04-13T18:03:00Z |
| publishDate | 2021-03-01 |
| publisher | Research Center of Neurology |
| record_format | Article |
| series | Анналы клинической и экспериментальной неврологии |
| spelling | doaj.art-d385367ea39a4f6b8e2b22c055847c022022-12-22T02:36:12ZengResearch Center of NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-25332021-03-0115151210.25692/ACEN.2021.1.1535Internal carotid and vertebral artery dissection: an approach to patient managementLyudmila A. Kalashnikova0Larisa A. Dobrynina1Marina Yu Maksimova2Marine M. Tanashyan3Maria S. Danilova4Marina V. Dreval5Research Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyWe aimed to evaluate the treatment results in patients with internal carotid artery (ICA) and vertebral artery (VA) dissection. Materials and methods. We examined 285 patients (122 men and 163 women, mean age 37.7 8.1 years) with ICA dissection (n = 147), VA dissection (n = 122), or a combination of both (n = 16). The dissection presented as ischemic stroke in 175 patients and with local symptoms in the others. Out of 173 patients, 156 were managed conservatively. Efficacy of the conservative treatment in first 3 months was assessed in 143 patients who received anticoagulants (AC; n = 38), antiplatelets (AP; n = 42), both (n = 45) or no antithrombotic therapy (n = 18). Results. Good functional recovery (02 points on the modified Rankin Scale) after 3 months was noted in 70% of patients, with no statistically significant differences between the different treatment types. There were 3 (2%) deaths in patients with severe stroke receiving AC. Recurrent ischemic stroke occurred in 10% of patients most often (86%) occurring in the first 3 weeks and triggered by head movement, straining, or fluctuating blood pressure. No statistically significant differences were found between different conservative treatments. However, there was a tendency towards increased frequency of recurrent stroke in patients without antithrombotic therapy (22%), as compared with patients receiving AC (4%) or AP (12%). There were no strokes in 110 patients with local symptoms due to ICA/VA dissection during the observation period. Conclusion. There were no statistically significant differences in AC and AP efficacy in patients with ICA or VA dissection. A neck brace to prevent head movement and control of blood pressure are advisable alongside pharmacological therapy.https://annaly-nevrologii.com/journal/pathID/article/viewFile/720/561dissectioninternal carotid arteryvertebral artery, treatmentanticoagulantsantiplatelets |
| spellingShingle | Lyudmila A. Kalashnikova Larisa A. Dobrynina Marina Yu Maksimova Marine M. Tanashyan Maria S. Danilova Marina V. Dreval Internal carotid and vertebral artery dissection: an approach to patient management Анналы клинической и экспериментальной неврологии dissection internal carotid artery vertebral artery, treatment anticoagulants antiplatelets |
| title | Internal carotid and vertebral artery dissection: an approach to patient management |
| title_full | Internal carotid and vertebral artery dissection: an approach to patient management |
| title_fullStr | Internal carotid and vertebral artery dissection: an approach to patient management |
| title_full_unstemmed | Internal carotid and vertebral artery dissection: an approach to patient management |
| title_short | Internal carotid and vertebral artery dissection: an approach to patient management |
| title_sort | internal carotid and vertebral artery dissection an approach to patient management |
| topic | dissection internal carotid artery vertebral artery, treatment anticoagulants antiplatelets |
| url | https://annaly-nevrologii.com/journal/pathID/article/viewFile/720/561 |
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