Prognostic significance of pulsatile tinnitus in cervical artery dissection

L. Kellert, Manja Kloss, A. Pezzini, S. Debette, Didier Leys, Valeria Caso, Vincent Thijs, Anna Bersano, Emmanuel Touzé, Turgut Tatlisumak, C. Traenka, Philippe A. Lyrer, Stefan Engelter, Tiina M. Metso, Caspar Grond-Ginsbach, Massimo Pandolfo, Marie Bodenant, Fabien Louillet, Jean Louis Mas, Sandrine DeltourAnne Léger, Sandrine Canaple, Olivier Godefroy, Yannick Béjot, Thierry Moulin, Fabrice Vuillier, Michael Dos Santos, Rainer Malik, Ingrid Hausser, Tobias Brandt, Constanze Thomas-Feles, Ralf Weber, Paolo Costa, Loris Poli, Andrea Morotti, A. Padovani, Silvia Lanfranconi, Silvia Lanfranconi, Carlo Ferrarese, Giacomo Giacolone, Stefano Paolucci, Stefano Paolucci, Florian Hatz, Dominique Gisler, Margareth Amort, Steve Bevan, Ayse Altintas

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1183-1187
Number of pages5
JournalEuropean Journal of Neurology
Volume23
Issue number7
DOIs
Publication statusPublished - Jul 1 2016

Fingerprint

Tinnitus
Dissection
Arteries
Stroke
Odds Ratio
Confidence Intervals
National Institutes of Health (U.S.)
Internal Carotid Artery Dissection
Horner Syndrome
Neck Pain
Documentation
Logistic Models
Regression Analysis

Keywords

  • acute ischaemic stroke
  • cervical artery dissection
  • outcome
  • pulsatile tinnitus

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Kellert, L., Kloss, M., Pezzini, A., Debette, S., Leys, D., Caso, V., ... Altintas, A. (2016). Prognostic significance of pulsatile tinnitus in cervical artery dissection. European Journal of Neurology, 23(7), 1183-1187. https://doi.org/10.1111/ene.13031

Prognostic significance of pulsatile tinnitus in cervical artery dissection. / Kellert, L.; Kloss, Manja; Pezzini, A.; Debette, S.; Leys, Didier; Caso, Valeria; Thijs, Vincent; Bersano, Anna; Touzé, Emmanuel; Tatlisumak, Turgut; Traenka, C.; Lyrer, Philippe A.; Engelter, Stefan; Metso, Tiina M.; Grond-Ginsbach, Caspar; Pandolfo, Massimo; Bodenant, Marie; Louillet, Fabien; Mas, Jean Louis; Deltour, Sandrine; Léger, Anne; Canaple, Sandrine; Godefroy, Olivier; Béjot, Yannick; Moulin, Thierry; Vuillier, Fabrice; Dos Santos, Michael; Malik, Rainer; Hausser, Ingrid; Brandt, Tobias; Thomas-Feles, Constanze; Weber, Ralf; Costa, Paolo; Poli, Loris; Morotti, Andrea; Padovani, A.; Lanfranconi, Silvia; Lanfranconi, Silvia; Ferrarese, Carlo; Giacolone, Giacomo; Paolucci, Stefano; Paolucci, Stefano; Hatz, Florian; Gisler, Dominique; Amort, Margareth; Bevan, Steve; Altintas, Ayse.

In: European Journal of Neurology, Vol. 23, No. 7, 01.07.2016, p. 1183-1187.

Research output: Contribution to journalArticle

Kellert, L, Kloss, M, Pezzini, A, Debette, S, Leys, D, Caso, V, Thijs, V, Bersano, A, Touzé, E, Tatlisumak, T, Traenka, C, Lyrer, PA, Engelter, S, Metso, TM, Grond-Ginsbach, C, Pandolfo, M, Bodenant, M, Louillet, F, Mas, JL, Deltour, S, Léger, A, Canaple, S, Godefroy, O, Béjot, Y, Moulin, T, Vuillier, F, Dos Santos, M, Malik, R, Hausser, I, Brandt, T, Thomas-Feles, C, Weber, R, Costa, P, Poli, L, Morotti, A, Padovani, A, Lanfranconi, S, Lanfranconi, S, Ferrarese, C, Giacolone, G, Paolucci, S, Paolucci, S, Hatz, F, Gisler, D, Amort, M, Bevan, S & Altintas, A 2016, 'Prognostic significance of pulsatile tinnitus in cervical artery dissection', European Journal of Neurology, vol. 23, no. 7, pp. 1183-1187. https://doi.org/10.1111/ene.13031
Kellert L, Kloss M, Pezzini A, Debette S, Leys D, Caso V et al. Prognostic significance of pulsatile tinnitus in cervical artery dissection. European Journal of Neurology. 2016 Jul 1;23(7):1183-1187. https://doi.org/10.1111/ene.13031
Kellert, L. ; Kloss, Manja ; Pezzini, A. ; Debette, S. ; Leys, Didier ; Caso, Valeria ; Thijs, Vincent ; Bersano, Anna ; Touzé, Emmanuel ; Tatlisumak, Turgut ; Traenka, C. ; Lyrer, Philippe A. ; Engelter, Stefan ; Metso, Tiina M. ; Grond-Ginsbach, Caspar ; Pandolfo, Massimo ; Bodenant, Marie ; Louillet, Fabien ; Mas, Jean Louis ; Deltour, Sandrine ; Léger, Anne ; Canaple, Sandrine ; Godefroy, Olivier ; Béjot, Yannick ; Moulin, Thierry ; Vuillier, Fabrice ; Dos Santos, Michael ; Malik, Rainer ; Hausser, Ingrid ; Brandt, Tobias ; Thomas-Feles, Constanze ; Weber, Ralf ; Costa, Paolo ; Poli, Loris ; Morotti, Andrea ; Padovani, A. ; Lanfranconi, Silvia ; Lanfranconi, Silvia ; Ferrarese, Carlo ; Giacolone, Giacomo ; Paolucci, Stefano ; Paolucci, Stefano ; Hatz, Florian ; Gisler, Dominique ; Amort, Margareth ; Bevan, Steve ; Altintas, Ayse. / Prognostic significance of pulsatile tinnitus in cervical artery dissection. In: European Journal of Neurology. 2016 ; Vol. 23, No. 7. pp. 1183-1187.
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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.",
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T1 - Prognostic significance of pulsatile tinnitus in cervical artery dissection

AU - Kellert, L.

AU - Kloss, Manja

AU - Pezzini, A.

AU - Debette, S.

AU - Leys, Didier

AU - Caso, Valeria

AU - Thijs, Vincent

AU - Bersano, Anna

AU - Touzé, Emmanuel

AU - Tatlisumak, Turgut

AU - Traenka, C.

AU - Lyrer, Philippe A.

AU - Engelter, Stefan

AU - Metso, Tiina M.

AU - Grond-Ginsbach, Caspar

AU - Pandolfo, Massimo

AU - Bodenant, Marie

AU - Louillet, Fabien

AU - Mas, Jean Louis

AU - Deltour, Sandrine

AU - Léger, Anne

AU - Canaple, Sandrine

AU - Godefroy, Olivier

AU - Béjot, Yannick

AU - Moulin, Thierry

AU - Vuillier, Fabrice

AU - Dos Santos, Michael

AU - Malik, Rainer

AU - Hausser, Ingrid

AU - Brandt, Tobias

AU - Thomas-Feles, Constanze

AU - Weber, Ralf

AU - Costa, Paolo

AU - Poli, Loris

AU - Morotti, Andrea

AU - Padovani, A.

AU - Lanfranconi, Silvia

AU - Lanfranconi, Silvia

AU - Ferrarese, Carlo

AU - Giacolone, Giacomo

AU - Paolucci, Stefano

AU - Paolucci, Stefano

AU - Hatz, Florian

AU - Gisler, Dominique

AU - Amort, Margareth

AU - Bevan, Steve

AU - Altintas, Ayse

PY - 2016/7/1

Y1 - 2016/7/1

N2 - 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.

AB - 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.

KW - acute ischaemic stroke

KW - cervical artery dissection

KW - outcome

KW - pulsatile tinnitus

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