Clinical Analysis Of 98 Cases Of Cervical Artery Dissection

BackgroundCarotid artery dissection is one of the main causes of stroke in young people.Due to the limited understanding of it by clinicians,it often leads to missed diagnosis or misdiagnosis.ObjectiveTo analyze the clinical characteristics of patients with carotid artery dissection and to promote the early identification,early diagnosis and treatment of carotid artery dissection.MethodsThe clinical features,imaging features and treatment measures of patients with carotid artery dissection diagnosed by computed tomography angiography(CTA),digital subtraction angiography(DSA),magnetic resonance imaging(MRI),magnetic resonance angiography(MRA),and high-resolution MRI were analyzed in Department of Neurology and nerve intervention,Second Affiliated Hospital of Zhejiang University Medical College from October 2013 to 2017 May.Results98 cases of cervical artery dissection were included,the average age were(45.8±13.8)years,male 75(77%),and 23 women(23%).There were 67 cases of internal carotid artery dissection with an average age of 50.8 ± 11.7 years,and 31 cases of vertebral artery dissection with a mean age of(34.9 ± 11.5)years.There were significant differences in age(t=7.757,P=0.006)and sex(?2=9.890,P=0.002)in patients with intervertebral artery dissection and internal carotid artery dissection.Differences were statistically significant regarding as the risk of limb dysfunction,inarticulate,dizziness between patients with vertebral artery dissection or internal carotid artery dissection(P<0.05).The risk of limbs numbness and headache in patients with internal carotid artery dissection were lower than those in patients with vertebral artery dissection(P<0.05).There had no significant difference regarding as the risk of Homer syndrome,disorder of consciousness,blurred vision,convulsions,amaurosis,abnormal behavior(P>0.05).There had no significant difference regarding as the risk of hypertension history,diabetes mellitus history,hyperlipidemia,hyperhomocysteinemia,smoking,drinking,atrial fibrillation,coronary heart disease,past cerebral infarction,past cerebral hemorrhage,neck trauma history(P>0.05).The imaging features of arterial dissection mainly include local aneurysm dilation,line sign,flame sign,crescent high sign in the arterial wall and so on.Antiplatelet therapy was performed in 82 cases(84%),anticoagulant therapy in 12 cases(12%),and intravascular therapy in 4 cases(4%).ConclusionsThe clinical symptoms of patients with cervical artery dissection had different forms.It is determined mainly by the location of the interlayer and the vessels involved.Patients with light symptoms can be asymptomatic,or simple head and neck pain,and the severe patients may be characterized by transient ischemic attack and ischemic stroke.Its characteristic imaging findings can help diagnose,and standardized medical treatment is very important for the dissection of the neck artery.