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A total of 2,027 studies were reviewed; 118 patients were identified in 79 studies. Seventy-four percent of patients with ACAD (n = 73) and 87% with PCAD (n = 47) were male (p < 0.0001). When patients with preceding trauma were excluded, t his male predominance persisted. All patients had evidence of cerebral ischemia at the time of diagnosis. Headache was reported in approximately half of patients. Sixty percent of ACAD were intracranial. ACAD with no preceding trauma were more commonl y intracranial than those preceded by significant trauma (86 vs 25%, p = 0.002). The most common location for PCAD was the vertebral artery at the level of the C1-C2 vertebral bodies (53%). Recurrent ischemic events after the diagnosis of dissection wer e reported in 15% of PCAD and 5% of ACAD cases. None of the PCAD group and 10% of the ACAD group had recurrent dissections. There is a marked male predominance among children with cerebral arterial dissections that is not explained by trauma. Unlike adu lt ACAD, childhood ACAD are most commonly intracranial. Spontaneous ACAD, in particular, tend to be intracranial, while post-traumatic ACAD are more often extracranial. The vertebral artery segment most susceptible to dissection is similar between child ren and adults. |
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arterial dissection
arterial dissection,childhood
arterial dissection,intracranial
arterial dissection,precipitating events
arterial dissection,spontaneous
cerebrovascular accident
cerebrovascular accident,infancy and childhood
children
neck pain
pain,head
precipitating factors
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