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Journal of Neurology

, Volume 266, Issue 2, pp 298–305 | Cite as

Characteristics and relative factors of headache caused by cervicocerebral artery dissection

  • Yuhan Wang
  • Wenchao Cheng
  • Yajun LianEmail author
  • Jing ZhangEmail author
  • Yake Zheng
  • Yiying Hu
  • Yuan Chen
  • Shouyi Wu
  • Zhi Huang
  • Yinping Shi
Original Communication

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.

Keywords

Cervicocerebral artery dissection Headache and neck pain Pain features Relative factors 

Notes

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].

Compliance with ethical standards

Conflicts of interest

The authors declare that there is no conflict of interest.

Ethical approval

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

Informed consent

All subjects gave their informed consent prior to their inclusion in the study.

Supplementary material

415_2018_9111_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 15 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
  2. 2.Department of CardiologyHenan Provincial People’s HospitalZhengzhouChina
  3. 3.Department of RehabilitationAffiliated Hospital of Xuzhou Medical UniversityXuzhouChina

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