Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review

Nolwenn Riou-Comte,1 Gioia Mione,1 Lisa Humbertjean,1 Marie-Alexia Ottenin,2 Jean-Christophe Lacour,1 Sébastien Richard1,3 1Department of Neurology, Stroke Unit, University Hospital of Nancy, Nancy Cedex, France; 2Department of Neuroradiology, University Hospital of Nancy, Nancy Cedex, F...

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Autores principales:	Riou-Comte N, Mione G, Humbertjean L, Ottenin MA, Lacour JC, Richard S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Cerebral infarction elderly false aneurysm Horner syndrome old patients spontaneous cervical artery dissection Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/d0622af4cb1547c3b6eb3b6553ba8ef8
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spelling	oai:doaj.org-article:d0622af4cb1547c3b6eb3b6553ba8ef82021-12-02T00:05:19ZSpontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review1178-1998https://doaj.org/article/d0622af4cb1547c3b6eb3b6553ba8ef82017-08-01T00:00:00Zhttps://www.dovepress.com/spontaneous-cervical-artery-dissection-in-patients-aged-over-70-years--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Nolwenn Riou-Comte,1 Gioia Mione,1 Lisa Humbertjean,1 Marie-Alexia Ottenin,2 Jean-Christophe Lacour,1 Sébastien Richard1,3 1Department of Neurology, Stroke Unit, University Hospital of Nancy, Nancy Cedex, France; 2Department of Neuroradiology, University Hospital of Nancy, Nancy Cedex, France; 3Centre d’Invesigation Clinique Plurithématique Pierre Drouin CIC-P 1433 INSERM U1116, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France Objective: Spontaneous cervical artery dissection (CAD) is a cerebrovascular disease typically considered to affect the young population. Literature reports cases in the elderly only as incidental findings, making the diagnosis unlikely in older patients. Incidence and pathogeny in this specific population remain to be assessed.Methods: We reviewed patients aged over 70 years admitted for spontaneous CAD in the Stroke Unit of the University Hospital of Nancy (northeastern France) over a period of 12 years as well as all reported cases in literature.Results: During this period, only two patients aged over 70 years were diagnosed with internal carotid artery dissection in our center. The first patient was diagnosed with the typical radiological feature of long tapered stenosis due to mural hematoma. The second patient presented with the classic painful Horner syndrome. Literature review identified only two case reports and eight studies with an age range above 70 years. Headache was present in nearly all documented cases. Radiological features were the same as those usually described in younger patients.Conclusions: Even if spontaneous CAD in patients aged over 70 years would appear to be rare, it does occur with comparable clinical and radiological features as in the younger population. CAD is probably underdiagnosed in this population due to a higher prevalence of more common causes of stroke at this age. However, a simple investigation into headache or the Horner syndrome during the patient’s diagnostic workup would lead to adapted exploration of cervical arteries and improve detection of CAD in the elderly. Keywords: cerebral infarction, elderly, false aneurysm, Horner syndrome, old patients, spontaneous cervical artery dissection Riou-Comte NMione GHumbertjean LOttenin MALacour JCRichard SDove Medical PressarticleCerebral infarctionelderlyfalse aneurysmHorner syndromeold patientsspontaneous cervical artery dissectionGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1355-1362 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cerebral infarction elderly false aneurysm Horner syndrome old patients spontaneous cervical artery dissection Geriatrics RC952-954.6
spellingShingle	Cerebral infarction elderly false aneurysm Horner syndrome old patients spontaneous cervical artery dissection Geriatrics RC952-954.6 Riou-Comte N Mione G Humbertjean L Ottenin MA Lacour JC Richard S Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review
description	Nolwenn Riou-Comte,1 Gioia Mione,1 Lisa Humbertjean,1 Marie-Alexia Ottenin,2 Jean-Christophe Lacour,1 Sébastien Richard1,3 1Department of Neurology, Stroke Unit, University Hospital of Nancy, Nancy Cedex, France; 2Department of Neuroradiology, University Hospital of Nancy, Nancy Cedex, France; 3Centre d’Invesigation Clinique Plurithématique Pierre Drouin CIC-P 1433 INSERM U1116, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France Objective: Spontaneous cervical artery dissection (CAD) is a cerebrovascular disease typically considered to affect the young population. Literature reports cases in the elderly only as incidental findings, making the diagnosis unlikely in older patients. Incidence and pathogeny in this specific population remain to be assessed.Methods: We reviewed patients aged over 70 years admitted for spontaneous CAD in the Stroke Unit of the University Hospital of Nancy (northeastern France) over a period of 12 years as well as all reported cases in literature.Results: During this period, only two patients aged over 70 years were diagnosed with internal carotid artery dissection in our center. The first patient was diagnosed with the typical radiological feature of long tapered stenosis due to mural hematoma. The second patient presented with the classic painful Horner syndrome. Literature review identified only two case reports and eight studies with an age range above 70 years. Headache was present in nearly all documented cases. Radiological features were the same as those usually described in younger patients.Conclusions: Even if spontaneous CAD in patients aged over 70 years would appear to be rare, it does occur with comparable clinical and radiological features as in the younger population. CAD is probably underdiagnosed in this population due to a higher prevalence of more common causes of stroke at this age. However, a simple investigation into headache or the Horner syndrome during the patient’s diagnostic workup would lead to adapted exploration of cervical arteries and improve detection of CAD in the elderly. Keywords: cerebral infarction, elderly, false aneurysm, Horner syndrome, old patients, spontaneous cervical artery dissection
format	article
author	Riou-Comte N Mione G Humbertjean L Ottenin MA Lacour JC Richard S
author_facet	Riou-Comte N Mione G Humbertjean L Ottenin MA Lacour JC Richard S
author_sort	Riou-Comte N
title	Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review
title_short	Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review
title_full	Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review
title_fullStr	Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review
title_full_unstemmed	Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review
title_sort	spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/d0622af4cb1547c3b6eb3b6553ba8ef8
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Spontaneous cervical artery dissection in patients aged over 70 years: two cases and systematic literature review

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