Key result
Conservative management of unruptured vertebral artery dissection shows 0% ischemic or hemorrhagic events.
Why the study?
The natural course of unruptured vertebral artery dissection remains unclear with variable clinical manifestations and outcomes.
Does conservative management result in favorable clinical outcomes in patients with unruptured vertebral artery dissection?
Observational (n=7)
No
Does conservative management result in favorable clinical outcomes in patients with unruptured vertebral artery dissection?
The natural course of unruptured vertebral artery dissection appears non-aggressive, suggesting that conservative management with anticoagulants or antiplatelet agents is a viable strategy.
Answers are grounded in this paper and cite their sources.
Conservative management may be viable for unruptured vertebral artery dissection; leaves open confirmation in prospective trials.
Objective: The natural course of unruptured vertebral artery dissection remains unclear.The clinical manifestation of unruptured vertebral artery dissection varies from headache, focal neurologic deficits caused by ischemia to subarachnoid hemorrhage with high mortality.The purpose of this study is to investigate the clinical course of unruptured vertebral artery dissection.Methods: From March 2011 to April 2013, 7 patients with headache or nuchal pain by spontaneous vertebral artery dissection visited our institute were retrospectively reviewed.Their clinical data was obtained by medical records and radiologic studies including computed tomographic angiography, magnetic resonance imaging, magnetic resonance angiography and digital subtraction angiography.Results: No patient experienced fatal outcome by subarachnoid hemorrhage or vertebrobasilar ischemia during follow-up period.Radiologic studies also did not show the evidence of subarachnoid hemorrhage or vertebrobasilar ischemia.Followup angiography showed the decreased size or disappearance of aneurysm in 3 patients.Conclusion: This study suggests that the natural course of unruptured vertebral artery dissection is not aggressive.Patients with unruptured vertebral artery dissection could be managed with conservative treatment including anticoagulants and/or antiplatelet agents.
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Kim et al. (2013) conducted an observational in Unruptured vertebral artery dissection (n=7). Conservative management was evaluated on Subarachnoid hemorrhage or vertebrobasilar ischemia. Conservative management of unruptured vertebral artery dissection resulted in no instances of subarachnoid hemorrhage or vertebrobasilar ischemia during a mean follow-up of 10.4 months.
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