Prognostic significance of pulsatile tinnitus in cervical artery dissection. (27th April 2016)

• Record Type: Journal Article
• Authors: Kellert, L.; Kloss, M.; Pezzini, A.; Debette, S.; Leys, D.; Caso, V.; Thijs, V. N.; Bersano, A.; Touzé, E.; Tatlisumak, T.; Traenka, C.; Lyrer, P. A.; Engelter, S. T.; Metso, T. M.; Grond‐Ginsbach, C.
• Other Names: Pandolfo Massimo investigator.; Bodenant Marie investigator.; Louillet Fabien investigator.; Mas Jean‐Louis investigator.; Deltour Sandrine investigator.; Léger Anne investigator.; Canaple Sandrine investigator.; Godefroy Olivier investigator.; Béjot Yannick investigator.; Moulin Thierry investigator.; Vuillier Fabrice investigator.; Dos Santos Michael investigator.; Malik Rainer investigator.; Hausser Ingrid investigator.; Brandt Tobias investigator.; Thomas‐Feles Constanze investigator.; Weber Ralf investigator.; Costa Paolo investigator.; Poli Loris investigator.; Morotti Andrea investigator.; Padovani Alessandro investigator.; Lanfranconi Silvia investigator.; Baron Pierluigi investigator.; Ferrarese Carlo investigator.; Giacolone Giacomo investigator.; Paolucci Stefano investigator.; Fluri Felix investigator.; Hatz Florian investigator.; Gisler Dominique investigator.; Amort Margareth investigator.; Bevan Steve investigator.; Altintas Ayse investigator.;
• Is Part Of: European journal of neurology. Volume 23:Number 7(2016:Jul.)
• Page Start: 1183
• Page End: 1187
• Publication Date: 2016-04-27
• Subjects: acute ischaemic stroke -- cervical artery dissection -- outcome -- pulsatile tinnitus; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.13031
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract : Background and purpose: Our aim was to investigate whether pulsatile tinnitus (PT) in cervical artery dissection (CeAD) has prognostic significance. Methods: All CeAD patients from the CADISP (Cervical Artery Dissection and Ischemic Stroke Patients) study with documentation of PT were analysed. The presence of PT was systematically assessed using a standardized questionnaire. Stroke severity at admission was defined according to the National Institutes of Health Stroke Scale (NIHSS). Excellent outcome after 3 months was defined as a modified Rankin Scale of 0–1. Results: Sixty‐three of 778 patients (8.1%) reported PT. PT+ patients presented less often with ischaemic stroke (41.3% vs. 63.9%, P < 0.001), more often with dissection in the internal carotid artery (85.7% vs. 64.2%, P = 0.001), less often with vessel occlusion (19.0% vs. 34.1%, P = 0.017) and more often with excellent outcome at 3 months (92.1% vs. 75.4%, P = 0.002). Logistic regression analysis identified PT as an independent predictor of excellent outcome after 3 months [odds ratio (OR) 3.96, 95% confidence interval (CI) 1.22–12.87] adjusted to significant outcome predictors NIHSS on admission (OR 0.82, 95% CI 0.79–0.86), Horner syndrome (OR 1.95, 95% CI 1.16–3.29) and vessel occlusion (OR 0.62, 95% CI 0.40–0.94) and to non‐significant predictors age, sex, pain and location of CeAD. Conclusion: The presence of PT in CeAD is associated with a benign clinical course and predicts a favourable outcome.