Clinical Features of Patients With Cervical Artery Dissection and Fibromuscular Dysplasia

被引：22

作者：

Bonacina, Sonia ^{[1
]}

Grassi, Mario ^{[2
]}

Zedde, Marialuisa ^{[1
]}

Zini, Andrea ^{[3
]}

Bersano, Anna ^{[4
]}

Gandolfo, Carlo ^{[5
]}

Silvestrelli, Giorgio ^{[6
]}

Baracchini, Claudio ^{[7
]}

Cerrato, Paolo ^{[1
]}

Lodigiani, Corrado ^{[8
]}

Marcheselli, Simona ^{[9
]}

Paciaroni, Maurizio ^{[10
,11
]}

Rasura, Maurizia ^{[12
]}

Cappellari, Manuel ^{[13
]}

Del Sette, Massimo ^{[14
]}

Cavallini, Anna ^{[15
]}

Morotti, Andrea ^{[16
]}

Micieli, Giuseppe ^{[17
]}

Lotti, Enrico Maria ^{[18
]}

DeLodovici, Maria Luisa ^{[19
]}

Gentile, Mauro ^{[3
]}

Magoni, Mauro ^{[20
]}

Azzini, Cristiano ^{[21
]}

Calloni, Maria Vittoria ^{[22
]}

Giorli, Elisa ^{[23
]}

Braga, Massimiliano ^{[24
]}

La Spina, Paolo ^{[25
]}

Melis, Fabio ^{[26
]}

Tassi, Rossana ^{[27
]}

Terruso, Valeria ^{[28
]}

Calabro, Rocco Salvatore ^{[29
]}

Piras, Valeria ^{[30
]}

Giossi, Alessia ^{[31
]}

Locatelli, Martina ^{[1
]}

Mazzoleni, Valentina ^{[1
]}

Pezzini, Debora ^{[1
]}

Sanguigni, Sandro ^{[32
]}

Zanferrari, Carla ^{[33
]}

Mannino, Marina ^{[34
]}

Colombo, Irene ^{[35
]}

Dallocchio, Carlo ^{[36
]}

Nencini, Patrizia ^{[37
]}

Bignamini, Valeria ^{[38
]}

Adami, Alessandro ^{[39
]}

Magni, Eugenio ^{[40
]}

Bella, Rita ^{[41
]}

Padovani, Alessandro ^{[1
]}

Pezzini, Alessandro ^{[1
]}

机构：

[1] Univ Brescia, Dipartimento Sci Clin & Sperimenlali, Clin Neurol, Brescia, Italy

[2] Univ Pavia, Unita Stat Med & Genom, Dipartimento Sci Sistema Nervoso & Comportamento, Pavia, Italy

[3] IRCCS, Azienda Unita Sanitaria Locale, SC Neurol Stroke Unit, Reggio Emilia, Italy

[4] IRCCS, Ist Sci Neurol Bologna, UOC Neurol & Rete Stroke Metropolitana, Osped Maggiore, Bologna, Italy

[5] Univ Genoa, Dipartimento Neurosci Riabilitaz Oftalmol, Genet & Sci Materno Infantili, Genoa, Italy

[6] Osped Carlo Poma, Stroke Unit, Dipartimento Neurosci, Mantua, Italy

[7] Azienda Osped Univ Padova, UOSD Stroke Unit & Lab Neurosonol, Padua, Italy

[8] IRCCS, Ctr Trombosi, Humanitas Res Hosp, Milan, Italy

[9] IRCCS, Neurol Urgenza & Stroke Unit, Humanitas Res Hosp, Milan, Italy

[10] Univ Perugia, Stroke Unit, Perugia, Italy

[11] Univ Perugia, Div Med Cardiovas, Perugia, Italy

[12] Univ Roma La Sapienza, Stroke Unit, Azienda Osped SantAndrea, Rome, Italy

[13] Azienda Osped Univ Integrata Borgo Trento, Stroke Unit, Verona, Italy

[14] Osped Galliera, UO Neurol, Genoa, Italy

[15] UC Malattie Cerebrovascolari & Stroke Unit, Pavia, Italy

[16] ASST Valle Camon, UO Neurol, Esine, Italy

[17] IRCCS Fdn Ist C Mondino, Neurol Urgenza, Pavia, Italy

[18] AUSL Romagna, UOC Neurol, Ravenna, Italy

[19] Univ Insubria, Osped Circolo, Varese, Italy

[20] ASST Spedali Civili Brescia, Stroke Unit, Neurol Vascolare, Brescia, Italy

[21] Azienda Osped Univ Ferrara CA, Dipartimento Neurosci & Riabilitaz, UO Neurol, Ferrara, Italy

[22] ASST Ovest Milanese, UO Neurol Stroke Unit, Osped Legnano, Milan, Italy

[23] Osped S Andrea, Unita Neurol, La Spezia, Italy

[24] ASST Vimercate, UOC Neurol, Vimercate, Italy

[25] Univ Messina, UOSD Stroke Unit, Dipartimento Med Clin & Sperimentale, Messina, Italy

[26] ASL Citta Torino, SS NeuroVascolare Osped Maria Vittoria, Turin, Italy

[27] Azienda Osped Univ Senese, UOC Stroke Unit, Siena, Italy

[28] Osped Villa Sofia, UO Neurol, Palermo, Italy

[29] Ctr Neurolesi Bonino Pulejo, Ist Ricovero & Cura Carattere Sci, Messina, Italy

[30] Azienda Osped G Brotzu, SC Neurol & Stroke Unit, Dipartimento Neurosci & Riabilitaz, Cagliari, Italy

[31] ASST Cremona, UO Neurol, Ist Ospitalieri, Cremona, Italy

[32] Osped Madonna Soccorso, San Benedetto Tronto, Dipartimento Neurol, Tronto, Italy

[33] ASST Melegnano Martesana, UOC Neurol Stroke Unit, Martesana, Italy

[34] Osped Civ, Stroke Unit, Palermo, Italy

[35] Osped Desio ASST Monza, SC Neurol & Unita Neurovascolare, Monza, Italy

[36] ASST Pavia, UOC Neurol, Dipartimento Area Med, Pavia, Italy

[37] Azienda Osped Univ Careggi, Univ Firenze, Stroke Unit, Florence, Italy

[38] Osped S Chiara, U0 Neurol, Stroke Unit, Trento, Italy

[39] IRCSS Sacro Cuore Negrar, Dipartimento Neurol, Stroke Ctr, Verona, Italy

[40] Ist Osped Poliambulanza, UO Neurol, Brescia, Italy

[41] Univ Catania, Sez Neurosci, Dipartimento Sci Med & Chirurg & Tecnol Avanzate, Catania, Italy

来源：

STROKE | 2021年 / 52卷 / 03期

关键词：

cohort studies; demography; dissection; follow-up studies; risk factors;

D O I：

10.1161/STROKEAHA.120.031579

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose: Observational studies have suggested a link between fibromuscular dysplasia and spontaneous cervical artery dissection (sCeAD). However, whether patients with coexistence of the two conditions have distinctive clinical characteristics has not been extensively investigated. Methods: In a cohort of consecutive patients with first-ever sCeAD, enrolled in the setting of the multicenter IPSYS CeAD study (Italian Project on Stroke in Young Adults Cervical Artery Dissection) between January 2000 and June 2019, we compared demographic and clinical characteristics, risk factor profile, vascular pathology, and midterm outcome of patients with coexistent cerebrovascular fibromuscular dysplasia (cFMD; cFMD+) with those of patients without cFMD (cFMD-). Results: A total of 1283 sCeAD patients (mean age, 47.8 +/- 11.4 years; women, 545 [42.5%]) qualified for the analysis, of whom 103 (8.0%) were diagnosed with cFMD+. In multivariable analysis, history of migraine (odds ratio, 1.78 [95% CI, 1.13-2.79]), the presence of intracranial aneurysms (odds ratio, 8.71 [95% CI, 4.06-18.68]), and the occurrence of minor traumas before the event (odds ratio, 0.48 [95% CI, 0.26-0.89]) were associated with cFMD. After a median follow-up of 34.0 months (25th to 75th percentile, 60.0), 39 (3.3%) patients had recurrent sCeAD events. cFMD+ and history of migraine predicted independently the risk of recurrent sCeAD (hazard ratio, 3.40 [95% CI, 1.58-7.31] and 2.07 [95% CI, 1.06-4.03], respectively) in multivariable Cox proportional hazards analysis. Conclusions: Risk factor profile of sCeAD patients with cFMD differs from that of patients without cFMD. cFMD and migraine are independent predictors of midterm risk of sCeAD recurrence.

引用

页码：821 / 829

页数：9

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