{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:54:50Z","timestamp":1780635290360,"version":"3.54.1"},"reference-count":17,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004955","name":"\u00d6sterreichische Forschungsf\u00f6rderungsgesellschaft","doi-asserted-by":"publisher","award":["898252"],"award-info":[{"award-number":["898252"]}],"id":[{"id":"10.13039\/501100004955","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Spontaneous cervical artery dissection (sCeAD) is one of the prime causes of ischemic stroke in young adults. Based on vessel wall imaging, steno-occlusive or expansive wall hematomas can be distinguished. It is unclear whether these two distinct morphological phenotypes reflect different pathophysiological processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>We aim to evaluate differences in clinical characteristics and long-term recurrence between patients with expansive and steno-occlusive mural wall hematoma in the acute phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Participants of the ReSect-study, one of the largest single-center cohort studies with long-term follow-up of sCeAD patients, with sufficient magnetic resonance imaging (MRI) were included. All available MRI scans were retrospectively evaluated for patients dichotomized to two groups: (1) mural hematoma causing steno-occlusive pathologies without expansion of total vessel diameter (steno-occlusive hematoma), and (2) mural hematoma causing vessel diameter expansion without lumen stenosis (expansive hematoma). Patients with mixed steno-occlusive and expansive vessel pathologies were excluded from the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 221 individuals were available for analysis. The pathognomonic vessel wall hematoma was steno-occlusive in 187 (84.6%) and expansive in 34 (15.4%). No difference was seen in patient demographics, clinical status at admission, laboratory parameters, family history, or the frequency of clinical stigmata for connective tissue disorders. Both patients with expansive and steno-occlusive mural hematoma had a high likelihood of suffering cerebral ischemia (64.7 vs 79.7). Still, time from symptom onset to diagnosis was significantly longer in those with expansive dissection (17.8 vs 7.8\u2009days, p\u2009=\u20090.02). Those with expansive dissections were more likely to have upper respiratory infection within 4\u2009weeks prior to dissection (26.5% vs 12.3%, p\u2009=\u20090.03). Upon follow-up, functional outcome was identical and groups did not differ in rate of sCeAD recurrence, but those with expansive mural hematoma at baseline more frequently had residual aneurysmal formation (41.2% vs 11.5%, p\u2009&lt;\u20090.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>As cerebral ischemia was frequent in both, our clinical results do not advise for differential treatment or follow-up based on the acute morphological phenotype. There was no clear evidence of a different aetiopathogenesis between patients with steno-occlusive or expansive mural hematoma in the acute phase. More mechanistic approaches are needed to elucidate potential differences in pathomechanism between both entities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data access:<\/jats:title>\n                    <jats:p>Anonymized data not published within this article will be made available by request from any qualified investigator.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930231185032","type":"journal-article","created":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T00:51:17Z","timestamp":1686963077000},"page":"1186-1192","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical characteristics and outcome in expansive compared with steno-occlusive mural hematoma in spontaneous cervical artery dissection"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2856-0101","authenticated-orcid":false,"given":"Lukas","family":"Mayer-Suess","sequence":"first","affiliation":[{"name":"Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Dejakum","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria"},{"name":"VASCage\u2014Research Centre on Clinical Stroke Research, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudrun","family":"Ratzinger","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venerology and Allergology, Medical University of Innsbruck, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke R","family":"Gizewski","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9836-2514","authenticated-orcid":false,"given":"Stefan","family":"Kiechl","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria"},{"name":"VASCage\u2014Research Centre on Clinical Stroke Research, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Knoflach","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria"},{"name":"VASCage\u2014Research Centre on Clinical Stroke Research, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000056"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70084-5"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103223441206"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000159739.24607.98"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318217e71c"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2013.00133"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.12.2646"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.643338"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.2.418"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00298-7"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2014.11"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000264892.92538.a9"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2018.03055"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010710"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-04686-7"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/03331024221079298"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/17474930231156081"}],"container-title":["International 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