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Updated: Jun 6, 2026
08:12
A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage
Published on: July 28, 2018
Long-Term Vascular Remodeling After Headache-Onset Intracranial Vertebral Artery Dissection
Rika Nakamura1, Ken Kazama1, Shintaro Inoue1
1From the Department of Neurosurgery, JCHO Tokyo Shinjuku Medical Center, 5-1 Tsukudomachi, Shinjuku-ku, Tokyo 162-0815, Japan.
AJNR. American Journal of Neuroradiology
|June 4, 2026
Summary
Headache-onset vertebral artery dissection shows dynamic changes over time. Modifiable factors like hypertension and alcohol predict progression, while male sex and specific MRI findings predict incomplete healing.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Vertebral artery dissection (VAD) with isolated headache presents unique vascular remodeling challenges.
- Long-term outcomes and progression factors in headache-onset VAD remain incompletely understood.
Purpose of the Study:
- To characterize chronic morphological outcomes of headache-onset intracranial VAD.
- To identify clinical and imaging predictors of incomplete healing and delayed progression.
Main Methods:
- Retrospective analysis of 179 patients with isolated headache-onset intracranial VAD.
- Longitudinal MRI follow-up to categorize remodeling (complete healing, quiescent, progression).
- Multivariable logistic regression to identify predictors, including intramural signal on DWI.
Main Results:
- Complete healing in 75.4% of patients over a median 67-month follow-up.
- Incomplete healing in 24.6%, with 8.9% showing delayed morphologic progression.
- Hypertension and alcohol use predicted progression; male sex, non-dominant artery, and early intramural DWI signal predicted incomplete healing.
Conclusions:
- Headache-onset VAD is a dynamic process with varied long-term outcomes.
- Progression linked to systemic stressors; incomplete healing to local vulnerabilities (DWI intramural signal as surrogate).
- Findings support risk-stratified surveillance and targeted hemodynamic management.
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