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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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