Incidence and outcome of cervical artery dissection - A population-based study
Incidence and outcome of cervical artery dissection - A population-based study
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DOI：
10.1212/01.wnl.0000244486.30455.71
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发表时间：
2006-11-28
期刊：
影响因子：
9.9
通讯作者：
Mokri, Bahram
中科院分区：
文献类型：
--
作者：
Lee, Vivien H.;Brown, Robert D., Jr.;Mokri, Bahram
背景资料：据报道，颈内动脉夹层（ICAD）的发病率为2.6 - 2.9/100，000，但椎动脉夹层（VAD）的可靠流行病学数据不可用。目的：确定颈动脉夹层（CAD）在特定人群中的发病率。研究方法：在IRB批准后，我们使用罗切斯特流行病学项目的病历链接系统识别1987 - 2003年期间明尼苏达州奥姆斯特德县诊断为自发性ICAD和VAD的所有患者。结果：48例冠心病患者中，ICAD 32例，VAD 18例。在奥姆斯特德县，ICAD的平均年发病率为1.72/100，000人口（95%CI，1.13至2.32），VAD为0.97/100，000人口（95%CI，0.52至1.4）。CAD的平均年发病率为2.6/100，000人群（95%CI，1.86 - 3.33）。CAD患者最常见的症状是头颈部疼痛（80%）、脑缺血（TIA或梗死）（56%）和Horner综合征（25%）。92%的患者结局良好（定义为修改后的兰金评分为0至2分）。在平均7.8年的随访期间，未观察到夹层复发。结论：在整个研究中，颈内动脉夹层的检出率约为椎动脉夹层的两倍，但在研究期的后半部分，椎动脉和颈内动脉夹层的发生率相当。社区中大多数颈动脉夹层患者的预后良好，与许多三级转诊系列相反，再次夹层很少。
Background: Incidence rates for internal carotid artery dissection (ICAD) have been reported to be 2.6 to 2.9 per 100,000, but reliable epidemiologic data for vertebral artery dissection (VAD) are not available. Objective: To determine the incidence rate of cervical artery dissection (CAD) in a defined population. Methods: With IRB approval, we used the medical record linkage system of the Rochester Epidemiology Project to identify all patients diagnosed with spontaneous ICAD and VAD for the period of 1987 - 2003 in Olmsted County, MN. Results: Of 48 patients with CAD, there were 32 patients with ICAD and 18 patients with VAD. In Olmsted County, the average annual incidence rate for ICAD was 1.72 per 100,000 population (95% CI, 1.13 to 2.32) and for VAD 0.97 per 100,000 population (95% CI, 0.52 to 1.4). The average annual incidence rate for CAD was 2.6 per 100,000 population (95% CI, 1.86 to 3.33). The most frequently encountered symptoms in CAD were head or neck pain (80%), cerebral ischemia (TIA or infarct) (56%), and Horner syndrome (25%). Good outcome (defined as modified Rankin score of 0 to 2) was seen in 92% of patients. No recurrence of dissection was observed during a mean 7.8 years of follow-up. Conclusions: Internal carotid artery dissection was detected approximately twice as frequently as vertebral artery dissection in the overall study, but in the latter half of the study period, vertebral artery and internal carotid artery dissection incidence rates were equivalent. The majority of cervical artery dissection patients in the community have excellent outcome, and contrary to many tertiary referral series, re-dissection is rare.