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Angiographic frequency of saccular intracranial aneurysms in patients with spontaneous cervical artery dissection
W I Schievink1, B Mokri, D G Piepgras
1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
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Patients with spontaneous cervical artery dissection have a higher frequency of intracranial aneurysms. This suggests a potential shared underlying arteriopathy in these vascular conditions.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- The underlying causes of intracranial aneurysms and spontaneous cervical artery dissection are not fully understood.
- A potential shared primary arteriopathy may link these two cerebrovascular disorders.
Purpose of the Study:
- To determine the frequency of intracranial aneurysms in patients diagnosed with spontaneous cervical artery dissection.
- To explore a possible commonality in the pathogenesis of these distinct vascular conditions.
Main Methods:
- Retrospective review of angiograms from 164 patients with spontaneous extracranial carotid or vertebral artery dissection.
- Analysis of diagnosed intracranial aneurysms within this patient cohort.
Main Results:
- Intracranial aneurysms were identified in 9 out of 164 patients (5.5%).
- The prevalence was higher in female patients (8.8%) compared to male patients (1.4%).
- This frequency was significantly greater than that found in the general population (1.1%).
Conclusions:
- Spontaneous cervical artery dissection is associated with a significantly higher incidence of intracranial aneurysms.
- These findings support the hypothesis of a common arteriopathy contributing to both conditions.
- Further research is warranted to elucidate the shared pathogenetic mechanisms.
Abstract:
The pathogenesis of intracranial aneurysms and spontaneous cervical artery dissection is incompletely understood but a primary arteriopathy, possibly similar in both disorders, may be of importance. To investigate the frequency of intracranial aneurysms in patients with spontaneous cervical artery dissection, the angiograms of 164 patients who were diagnosed at the Mayo Clinic as having spontaneous extracranial carotid or vertebral artery dissection were reviewed. Thirteen intracranial aneurysms were detected in nine (5.5%) of the 164 patients: eight (8.8%) of the 91 female patients and one (1.4%) of the 73 male patients. The frequency of intracranial aneurysms in these patients was significantly higher (p less than 0.01) than that observed in a recent angiographic study from the same institution, estimating the frequency of intracranial aneurysms in the general population (1.1%). The significance of these findings is discussed.