{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T13:58:24Z","timestamp":1780667904221,"version":"3.54.1"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The aim of this study was to investigate the clinical and radiological factors associated with the rupture of a vertebral artery dissecting aneurysm (VADA) and to evaluate whether the stagnation sign is a significant risk factor for rupture of VADA.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Clinical and radiological variables of 117 VADAs treated in a tertiary hospital from September 2008 to December 2020 were retrospectively reviewed. The stagnation sign is defined as the finding of contrast agent remaining in the lesion until the venous phase of angiography. Univariate and multivariate analyses were executed to reveal the associations between rupture status and VADA characteristics.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The rate of ruptured VADAs was 29.1% (34 of 117) and the stagnation sign was observed in 39.3% (46 of 117). Fusiform shape (OR 5.105, 95% CI 1.591\u201316.383, p = 0.006), irregular surface (OR 4.200, 95% CI 1.412\u201312.495, p = 0.010), posterior inferior cerebellar artery (PICA) involvement (OR 3.788, 95% CI 1.288\u201311.136, p = 0.016), and the stagnation sign (OR = 3.317, 95% CI 1.131\u20139.732, p = 0.029) were significantly related to rupture of VADA in multivariate logistic regression analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This study showed that fusiform shape, irregular surface, PICA involvement, and the stagnation sign may be independent risk factors for the rupture of VADA. Therefore, when the potential risk factors are observed in unruptured VADA, more aggressive treatment rather than follow-up or medical therapy may be considered.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2021.9.jns211848","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T21:17:39Z","timestamp":1641590259000},"page":"329-334","source":"Crossref","is-referenced-by-count":10,"title":["Clinical and radiological risk factors for rupture of vertebral artery dissecting aneurysm: significance of the stagnation sign"],"prefix":"10.3171","volume":"137","author":[{"given":"Hyeong Jin","family":"Lee","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwan Sung","family":"Lee","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bum Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Radiology, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Sam","family":"Shin","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Korean Neurosurg Soc","doi-asserted-by":"publisher","first-page":"109","DOI":"10.3340\/jkns.2008.44.3.109","article-title":"Vertebral artery dissection: natural history, clinical features and therapeutic considerations","volume":"44","author":"Park KW","year":"2008","unstructured":"Park KW, Park JS, Hwang SC, Im SB, Shin WH, Kim BT. 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