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Characteristics and relative factors of headache caused by cervicocerebral artery dissection

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Journal of Neurology Aims and scope Submit manuscript

Abstract

Objective

To analyze the characteristics and relative factors of headache and neck pain due to cervicocerebral artery dissection (CAD).

Methods

A total of 146 consecutive patients with CAD in Zhengzhou, China (2010–2017) were observed and registered prospectively. There were 60 (60/146) cases who complained of headache and neck pain, and we analyzed the characteristics of pain according to their clinical features. For the 130 (130/146) patients with complete clinical laboratory data, they were divided into two groups according to pain, and the relative factors of pain were analyzed.

Results

The headache and neck pain in 60 CAD patients was mostly acute onset (98.3%), 70.6% (12/17) of patients with anterior circulation dissection and 88.4% (38/43) of patients with posterior circulation dissection complained of moderate to severe pain. 41.2% (7/17) of patients with anterior circulation dissection had temporal pain, while 46.5% (20/43) of the patients with posterior circulation dissection had occipital pain. There were 23.5% (4/17) and 32.6% (14/43) of patients with anterior and posterior circulation dissection complained of throbbing pain, respectively, 23.5% (4/17) and 20.9% (9/43) of patients with anterior and posterior circulation dissection complained of pulsating pain. The pain could occur in the ipsilateral (40.0%), bilateral (52.7%), or contralateral (7.3%) sites of the dissection. In the 130 patients, there were 56 cases (43.1%) in the pain group, and 74 cases (56.9%) in the non-pain group. Multivariate logistic regression analysis showed that female gender (OR 4.01, 95% CI 1.63–9.85, P = 0.002), posterior circulation (OR 3.18, 95% CI 1.39–7.28, P = 0.006), history of headache (OR 4.72, 95% CI 1.08–20.52, P = 0.039), and low-density lipoprotein less than 1.8 mmol/L (OR 2.90, 95% CI 1.15–7.34, P = 0.025) were risk factors of the occurrence of the pain related to CAD.

Conclusion

The headache and neck pain caused by CAD is a moderate to severe pain occurring suddenly. The pain nature may be diverse but mostly like throbbing and pulsating. When the dissected artery is located in the posterior circulation, the pain is mostly in the occipital region, and mostly in the temporal region when the dissected artery is located in the anterior circulation. The pain can occur in ipsilateral, bilateral, or contralateral of the dissection. In addition, several factors might contribute to the occurrence of headache and neck pain.

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Acknowledgements

The authors thank the patients for their collaboration.

Funding

This study was supported by the grant from National Natural Science Foundation of China [no. 81771397]; The National Natural Science Foundation of China, Youth Science Foundation Project [no. 81701271].

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Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe east Road, Zhengzhou, 450052, Henan, China

    Yuhan Wang, Wenchao Cheng, Yajun Lian, Yake Zheng, Yuan Chen, Shouyi Wu, Zhi Huang & Yinping Shi

  2. Department of Cardiology, Henan Provincial People’s Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China

    Jing Zhang

  3. Department of Rehabilitation, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China

    Yiying Hu

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  1. Yuhan Wang
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Correspondence to Yajun Lian or Jing Zhang.

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The Ethics Committee of the First Affiliated Hospital of Zhengzhou University approved this study (Number: KW-2018-LW-006).

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Wang, Y., Cheng, W., Lian, Y. et al. Characteristics and relative factors of headache caused by cervicocerebral artery dissection. J Neurol 266, 298–305 (2019). https://doi.org/10.1007/s00415-018-9111-5

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