@article{d44d21bf45484aff93e5ac7fc33799a5,
title = "Clinical Features of Patients with Cervical Artery Dissection and Fibromuscular Dysplasia",
abstract = "Background and Purpose: Observational studies have suggested a link between fibromuscular dysplasia and spontaneous cervical artery dissection (sCeAD). However, whether patients with coexistence of the two conditions have distinctive clinical characteristics has not been extensively investigated. Methods: In a cohort of consecutive patients with first-ever sCeAD, enrolled in the setting of the multicenter IPSYS CeAD study (Italian Project on Stroke in Young Adults Cervical Artery Dissection) between January 2000 and June 2019, we compared demographic and clinical characteristics, risk factor profile, vascular pathology, and midterm outcome of patients with coexistent cerebrovascular fibromuscular dysplasia (cFMD; cFMD+) with those of patients without cFMD (cFMD-). Results: A total of 1283 sCeAD patients (mean age, 47.8±11.4 years; women, 545 [42.5%]) qualified for the analysis, of whom 103 (8.0%) were diagnosed with cFMD+. In multivariable analysis, history of migraine (odds ratio, 1.78 [95% CI, 1.13-2.79]), the presence of intracranial aneurysms (odds ratio, 8.71 [95% CI, 4.06-18.68]), and the occurrence of minor traumas before the event (odds ratio, 0.48 [95% CI, 0.26-0.89]) were associated with cFMD. After a median follow-up of 34.0 months (25th to 75th percentile, 60.0), 39 (3.3%) patients had recurrent sCeAD events. cFMD+ and history of migraine predicted independently the risk of recurrent sCeAD (hazard ratio, 3.40 [95% CI, 1.58-7.31] and 2.07 [95% CI, 1.06-4.03], respectively) in multivariable Cox proportional hazards analysis. Conclusions: Risk factor profile of sCeAD patients with cFMD differs from that of patients without cFMD. cFMD and migraine are independent predictors of midterm risk of sCeAD recurrence.",
keywords = "Adolescent, Adult, Carotid Arteries, Female, Fibromuscular Dysplasia, Humans, Italy, Male, Middle Aged, Migraine Disorders, Prevalence, Proportional Hazards Models, Recurrence, Risk Factors, Stroke, Vertebral Artery Dissection, Young Adult, cohort studies, demography, dissection, follow-up studies, risk factors, Adolescent, Adult, Carotid Arteries, Female, Fibromuscular Dysplasia, Humans, Italy, Male, Middle Aged, Migraine Disorders, Prevalence, Proportional Hazards Models, Recurrence, Risk Factors, Stroke, Vertebral Artery Dissection, Young Adult, cohort studies, demography, dissection, follow-up studies, risk factors",
author = "Sonia Bonacina and Mario Grassi and Marialuisa Zedde and Andrea Zini and Anna Bersano and Carlo Gandolfo and Cinzia Gandolfo and Giorgio Silvestrelli and Claudio Baracchini and Paolo Cerrato and Corrado Lodigiani and Simona Marcheselli and Maurizio Paciaroni and Maurizia Rasura and Manuel Cappellari and {Del Sette}, Massimo and Anna Cavallini and Andrea Morotti and Giuseppe Micieli and Lotti, {Enrico Maria} and Delodovici, {Maria Luisa} and Mauro Gentile and Marino Gentile and Mauro Magoni and Cristiano Azzini and Calloni, {Maria Vittoria} and Elisa Giorli and Massimiliano Braga and {La Spina}, Paolo and Fabio Melis and Rossana Tassi and Valeria Terruso and Calabr{\`o}, {Rocco Salvatore} and Valeria Piras and Alessia Giossi and Martina Locatelli and Valentina Mazzoleni and Valeria Mazzoleni and Debora Pezzini and Sandro Sanguigni and Carla Zanferrari and Marina Mannino and Maria Mannino and Irene Colombo and Ilaria Colombo and Carlo Dallocchio and Patrizia Nencini and Valeria Bignamini and Alessandro Adami and Eugenio Magni and Rita Bella and Alessandro Padovani and Alessandro Pezzini",
year = "2021",
doi = "10.1161/STROKEAHA.120.031579",
language = "English",
volume = "52",
pages = "821--829",
journal = "Stroke",
issn = "0039-2499",
publisher = "Wolters Kluwer Health",
}