PT  - JOURNAL ARTICLE
AU  - Yu, Chun
AU  - Zhu, Zhu
AU  - Li, Siying
AU  - Xu, Yi
AU  - Yan, Wei
AU  - Kang, Xiaocui
AU  - Li, Yao
AU  - Dong, Qiang
AU  - Tang, Weijun
AU  - Han, Xiang
TI  - Clinical and radiological features of medullary infarction caused by spontaneous vertebral artery dissection
AID  - 10.1136/svn-2021-001180
DP  - 2022 Jun 01
TA  - Stroke and Vascular Neurology
PG  - 245--250
VI  - 7
IP  - 3
4099  - http://svn.bmj.com/content/7/3/245.short
4100  - http://svn.bmj.com/content/7/3/245.full
SO  - Stroke Vasc Neurol2022 Jun 01; 7
AB  - Background and purpose Medullary infarction (MI) caused by spontaneous vertebral artery dissection (sVAD) is an important type of stroke. It is important to distinguish sVAD from other causes of stroke since the treatment strategies and prognosis were different between them. In this study, we aimed to explore the clinical and radiological features of MI in patients with acute MI caused by sVAD.Methods Patients with acute MI caused by sVAD and non-sVAD in a single tertiary hospital were enrolled from 2010 to 2020. Epidemiologic, clinical and image features were collected and analysed. MI lesions were categorised into three levels rostrocaudally and four arterial groups: anteromedial, anterolateral, lateral and posterior.Results A total of 128 patients with MI were enrolled with 47 cases of sVAD and 81 cases of non-sVAD. Patients with sVAD were younger than those with non-sVAD (med 44 years old vs 58 years old). The sVAD group was less likely to have hypertension (44.68% vs 67.90%; p=0.010) and diabetes (19.15% vs 45.69%; p=0.003), but more likely to have non-sudden onset (27.66% vs 9.87%, p=0.009), minor neck injury (19.15% vs 1.23%; p=0.001) and headache (46.81% vs 7.41%; p=0.000). Vertically, sVAD became more common in caudal medulla than in rostral medulla. Horizontally, the sVAD group was more likely to have lateral MI (91.48% vs 2.96%, p=0.000). In multivariable logistic regression analysis, age, non-sudden onset and headache were independently associated with sVAD with ORs of 0.935 (95% CI 0.892 to 0.981, p=0.006), 3.507 (95% CI 1.060 to 11.599, p=0.040) and 5.426 (95% CI 1.673 to 17.599, p=0.005).Conclusion sVAD was not uncommon in patients with MI, especially in patients with lateral MI. Young patients with headache and non-sudden onset should remind clinician the possibility of sVAD.Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author, Xiang Han, upon reasonable request.