Vertebrobasilar dissections: case series comparing patients with and without dissecting aneurysms

Area of Science:

• Neurology
• Vascular Surgery
• Radiology

Background:

• Vertebrobasilar dissections are increasingly diagnosed due to improved imaging.
• Dissecting aneurysms can complicate the clinical presentation and outcomes of vertebrobasilar dissections.

Purpose of the Study:

• Compare clinical profiles of patients with and without dissecting aneurysms in vertebrobasilar dissections.
• Identify predisposing factors for aneurysm development in these dissections.

Main Methods:

• Retrospective study of 30 patients with vertebrobasilar dissections.
• Patients divided into aneurysmal (n=7) and non-aneurysmal (n=23) groups.
• Analyzed clinical presentation, trauma association, and risk factors.

Main Results:

• Migraine with aura and female sex were more frequent in the aneurysmal dissection group (p=0.008 and p=0.03, respectively).
• Most dissections were spontaneous (57%), with others linked to trauma or infection.
• 14 of 19 patients (74%) were independent at 4-month follow-up.

Conclusions:

• Female sex and migraine with aura may predispose to acute dissecting aneurysms in vertebrobasilar dissections.
• Larger prospective studies are needed to confirm epidemiologic and etiologic factors.
• Further research is required for both intracranial and extracranial dissecting aneurysms.