ABSTRACT NUMBER: ESOC2026A316 POSTPARTUM VERTEBRAL ARTERY DISSECTION: CLINICAL FEATURES, COURSE, AND OUTCOMES IN A POOLED ANALYSIS OF CASE REPORTS

Abstract Background and aims Vertebral artery dissection (VAD) is an uncommon however potentially fatal condition. Pregnant and postpartum women are at a higher risk of developing VAD compared to the general population. Spontaneous arterial dissections possess an unclear pathogenesis and can be challenging to control. This study aimed to compile and examine the data from published cases on this subject. Methods We performed a literature search using MeSH terms of interest in PubMed, Google Scholar, Ovid, Web of Science, and Scopus databases to find studies on VAD following childbirth. Results A total 28 studies were identified through a database search. These studies included 44 postpartum VAD (PPVAD) patients with a mean age of 34.26 ± 3.5 years. The average duration from delivery to dissection was 24.37 ± 13.7 days. Sixty-four percent of patients experienced unilateral dissection, while thirty-six percent exhibited bilateral dissection; seventy percent claimed complete recovery, and nine percent did not attain full recovery. The predominant complaints included headaches (89%), cervical discomfort (64%), and hypertension (52%). The predominant diagnostic procedures employed were magnetic resonance imaging (MRI) at 64% and computed tomography (CT) angiography at 66%. Only 8 patients, constituting 18%, reported the utilization of electrocardiography (ECG). The documented results of patients with unilateral and bilateral postpartum VAD exhibited no statistical disparity. The majority of the research reviewed advocate for prompt suspension and management to enhance prognosis and minimize problems. Conclusions PPVAD is a critical medical disease; however, the majority of cases achieved complete recovery following an early and appropriate antithrombotic strategy tailored to each specific circumstance. Conflict of interest Rehab Adel Diab, Nour Shaheen, Abdelrahman Mohamed, Mahmoud Tarek Hefnawy, Dilawer Chofan Charo, and Mostafa Meshref had nothing to disclose.