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(Stroke. 1996;27:622-624.)
© 1996 American Heart Association, Inc.

Articles

Recurrent Spontaneous Arterial Dissections

Risk in Familial Versus Nonfamilial Disease

Wouter I. Schievink, MD; Bahram Mokri, MD; David G. Piepgras, MD James D. Kuiper, BS

From the Departments of Neurologic Surgery (W.I.S., D.G.P.), Neurology (B.M.), and Health Sciences Research (J.D.K.), Mayo Clinic, Rochester, Minn.

Background and Purpose Among patients with spontaneous cervical artery dissections, the risk of recurrent arterial dissection is relatively low at 1% per year, but this risk may be higher for patients with a family history of arterial dissections. We compared the risk of a recurrent arterial dissection in patients with familial versus nonfamilial disease.

Methods Long-term follow-up was established in 200 patients (104 women and 96 men with a mean age of 44.9 years) with spontaneous cervical artery dissections evaluated at a single institution between 1970 and 1990.

Results Among the 200 patients, 10 (5%) were identified who had a family history of spontaneous arterial dissections. In a multivariate analysis, family history was the only significant variable associated with the risk of recurrent dissection (²=15.51; P=.0001). A recurrent arterial dissection was identified in 5 (50%) of the 10 patients with familial disease compared with 11 (5.8%) of the 190 patients with nonfamilial disease, with an estimated relative risk of 6.3 (95% confidence interval, 2.2 to 18.3; P=.0007).

Conclusions Among patients with spontaneous cervical artery dissections, a family history of arterial dissection is an important risk factor for the development of a recurrent arterial dissection.

Key Words: aneurysm • cerebrovascular disorders • dissection • genetics

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