Abstract:
OBJECTIVE:To report a Brazilian series of spontaneous cervical arterial dissections, risk factors, warning symptoms, clinical manifestations, diagnostic tests, treatment and prognosis. METHOD:We performed the retrospective analysis of clinical and neuroradiological records (MRI, A-MRI and Angiography) of patients with this diagnosis who were evaluated in a tertiary hospital for the period of 1997-2003. RESULTS:48 patients (24 men) with median age 37.9 years: 26 patients with unilateral internal carotid dissection (ICAD), 15 with unilateral vertebral artery dissection (VAD) and 7 with multivessel dissections. All patients presented neurological deficits. Hypertension, smoking and dyslipidemia were the main risk factors. More than 80% of patients presented at least one initial symptom, most of them temporoparietal headache. 44% of patients with VAD and only 3.4% of patients with ICAD had neck pain. The median interval between the onset of symptom and the appearance of neurological deficit was 5.4 days for ICAD and 13.5 days for VAD. Five patients with ICAD presented preceding TIA. Angiography was performed in 93% of patients. In 42% of these patients, MRI and A-MRI were associated. In three patients the diagnosis was made just through cervical MRI. 75% of patients received anticoagulation. Two patients received intravenous thrombolytic therapy with no complications. Prognosis was good for all patients but two patients with bilateral ICAD died. CONCLUSION:Our results are similar to the literature, except for the low frequency of neck pain in ICAD patients and predominance of temporoparietal headache in cervical artery dissection patients. Vascular risk factors were commonly found.
journal_name
Arq Neuropsiquiatrjournal_title
Arquivos de neuro-psiquiatriaauthors
Campos CR,Evaristo EF,Yamamoto FI,Puglia P Jr,Lucato LT,Scaff Mdoi
10.1590/s0004-282x2004000300021subject
Has Abstractpub_date
2004-06-01 00:00:00pages
492-8issue
2Beissn
0004-282Xissn
1678-4227pii
S0004-282X2004000300021journal_volume
62pub_type
杂志文章abstract::Intravenous rt-PA is an effective recanalizing treatment for ischemic stroke within 4 and half hours from its onset (Onset-to-Treatment [OTT]), with the best result seen in those treated within 90 minutes OTT. Yet few patients currently are treated in this time frame. From the standpoint of process improvement or a le...
journal_title:Arquivos de neuro-psiquiatria
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journal_title:Arquivos de neuro-psiquiatria
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journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1994000300012
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journal_title:Arquivos de neuro-psiquiatria
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journal_title:Arquivos de neuro-psiquiatria
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journal_title:Arquivos de neuro-psiquiatria
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journal_title:Arquivos de neuro-psiquiatria
pub_type: 临床试验,杂志文章
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journal_title:Arquivos de neuro-psiquiatria
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journal_title:Arquivos de neuro-psiquiatria
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journal_title:Arquivos de neuro-psiquiatria
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journal_title:Arquivos de neuro-psiquiatria
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更新日期:1999-06-01 00:00:00
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journal_title:Arquivos de neuro-psiquiatria
pub_type: 临床试验,杂志文章
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更新日期:2001-03-01 00:00:00
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journal_title:Arquivos de neuro-psiquiatria
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更新日期:1992-09-01 00:00:00
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journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
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