OBJECTIVE:To report clinical and radiologic features of intracranial arterial dissections (IAD).BACKGROUND:The absence of external elastic lamina with a thin muscular layer and adventitia predispose to IAD. The frequency and pattern of IAD is unknown in Argentina. We report a single institution series of IAD from Buenos Aires, Argentina.DESIGN/METHODS:Data was retrospectively obtained from the FLENI Stroke Data Bank between 1994 and 2013. We assessed demographic characteristics, clinical presentation, diagnostic tests, acute treatment, and outcome at six months.RESULTS:Of 297 patients with cerebral arterial dissections (CAD), 117 (39%) were extracranial artery dissections (EAD), 97 (33%) were EAD/ IAD, and 83 (28%) were IAD. Mean age for IAD was 44±12 years, and 63% were men. Clinical presentation was: ischemic stroke (71%), pain/Horner/tinnitus (21%), transient ischemic attack (4%), and hemorrhagic stroke (4%).Diagnosis was made by MRI, angio-TC, ultrasound and/or digital subtraction angiography. The most frequent patterns were: stenosis (71%), occlusion (13%), dissection flap (7%), and dissecting aneurysm (8%). Patients were treated with antiaggregants (50%), anticoagulants (46%), r-TPA (2%), surgery (1%) or no treatment (1%).At six-months follow up, 63% of the patients had a mRS 0/1, 32% of 2/3, and 4% of 4/5. One patient died during follow up (1%)CONCLUSIONS:IAD represent a substantial proportion of CAD and may be a frequently underdiagnosed cause of stroke. Intraparenchymal hemorrhage seemed to occur less frequently in our series than previously reported.Study Supported by:
Disclosure: Dr. Dossi has nothing to disclose. Dr. Farez has received personal compensation for activities with Merck Serono. Dr. Farez has received research support from Novartis. Dr. Arena has nothing to disclose. Dr. Pujol Lereis has nothing to disclose. Dr. Povedano has nothing to disclose. Dr. Ameriso has nothing to disclose.
Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/P2.013?rss=1
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