{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:57:44Z","timestamp":1755226664764,"version":"3.43.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"\nOBJECTIVE<\/jats:title>\nThe prognosis of isolated headache intracranial vertebral artery dissection (iVAD) without subarachnoid hemorrhage (SAH) or stroke is unknown. The authors of this study aimed to evaluate isolated headache iVAD prognosis.<\/jats:p>\n<\/jats:sec>\n\nMETHODS<\/jats:title>\nThis is a single-center retrospective study of consecutive patients who presented with headache as their main complaint and underwent MRI between November 2016 and August 2022; those with acute isolated headache iVAD who were followed up for vascular morphological stability were eligible for study inclusion. The patients were divided into three groups based on the vascular morphology at initial diagnosis: aneurysm dilatation without stenosis (group 1), aneurysm dilatation with stenosis (group 2), and no aneurysm dilatation (group 3). Prognosis, time to radiological stability, and final vascular morphology were compared among the groups.<\/jats:p>\n<\/jats:sec>\n\nRESULTS<\/jats:title>\nOne hundred five patients with isolated headache iVAD were included in the study. During a median follow-up of 478 (IQR 143\u20131094) days, none of the patients developed SAH or stroke, but 3\/41 (7%) patients in group 1 underwent endovascular intervention for aneurysm enlargement. Patients in group 1 required significantly more long-term follow-up for morphological stability (p = 0.013), primarily due to aneurysm enlargement (p < 0.001), and were more likely to require surgical intervention (p = 0.043) than those in the other two groups. Residual aneurysm risk was significantly associated with initial vascular morphology in group 1 (OR 7.28, 95% CI 2.30\u201323.1, p < 0.001).<\/jats:p>\n<\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nMost patients with isolated headache iVAD had a favorable prognosis. However, patients with aneurysm dilatation without stenosis required the most careful follow-up, as this group had the highest aneurysm enlargement risk from early disease onset through the chronic phase. In such cases, patients may require surgical intervention to prevent critical conditions.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.7.jns24575","type":"journal-article","created":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T01:32:52Z","timestamp":1732325572000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["The impact of initial vascular morphology on outcomes in patients with intracranial vertebral artery dissection presenting with isolated headache"],"prefix":"10.3171","author":[{"given":"Akito","family":"Oshima","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan;"},{"name":"Department of Neurosurgery, Hodogaya Neurosurgical Clinic, Yokohama, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Higurashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hodogaya Neurosurgical Clinic, Yokohama, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Takase","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan;"},{"name":"Department of Neurosurgery, Hodogaya Neurosurgical Clinic, Yokohama, Japan;"},{"name":"YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University Hospital, Yokohama, Japan;"},{"name":"Departments of Radiology and"},{"name":"Neurology, Massachusetts General Hospital, Charlestown, Massachusetts; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyosuke","family":"Asada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hodogaya Neurosurgical Clinic, Yokohama, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachiko","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hodogaya Neurosurgical Clinic, Yokohama, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kensuke","family":"Tateishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan;"},{"name":"Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Stroke","first-page":"1837","article-title":"Prognosis and safety of anticoagulation in intracranial artery dissections in adults","volume":"38","author":"Metso TM","year":"2007","unstructured":"Metso TM, Metso AJ, Helenius J, Prognosis and safety of anticoagulation in intracranial artery dissections in adults. 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