Giossi A. et alSupplemental MaterialGiossi A, Ritelli M, Costa P, et al. Connective Tissue Anomalies in Patients with SpontaneousCervical Artery DissectionContentse-Methodse-ReferencesTable-e1Figure e-11

Supplemental Material

Giossi A, Ritelli M, Costa P, et al. Connective Tissue Anomalies in Patients with Spontaneous Cervical Artery Dissection

Contents

e-Methods

e-References

Table-e1

Figure e-1

e-Methods

Definition of traumatic CeAD

We considered mechanisms of trauma associated with CeAD as previously described [e1]. In particular, trauma preceding CeAD was defined as: 1) any direct mechanical impact to the neck region; or 2) any impact to the head with indirect involvement of the neck region; or 3) any mechanical activity causing extraordinarily increased intra-thoracic pressure (e.g., heavy lifting), which had occurred within 1 month prior to first symptoms of dissection. Traumatic events leading to medical examination or hospitalization were considered “major” and all others were “minor”.

Risk factor definition

Vascular risk factors were defined and dichotomized as follows: hypertension, systolic blood pressure ≥140 mm Hg and diastolic pressure ≥90 mm Hg in two separate measurements after the acute phase or use of antihypertensive drugs before recruitment; diabetes mellitus, history of diabetes, use of hypoglycemic agent or insulin, or fasting glucose ≥7.0 mmol/l; current smoking, including former smokers who had quit smoking for 6 months before the index event;

hypercholesterolemia, cholesterol serum levels ≥5.7 mmol/l or use of cholesterol-lowering drugs;

migraine (personal history of headache was assessed in all patients by study physicians during a

face-to-face interview in both acute phase and follow-up evaluations), as migraine without aura

(MO) and migraine with aura (MA) according to the diagnostic criteria of the International

Headache Society (IHS) [e2].

e-References

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Figure e-1

Mean score of connective tissue anomalies in patients with spontaneous cervical artery dissection (CeAD) and patients with ischemic stroke unrelated to cervical artery dissection (non-CeAD IS).

Box plots indicate interquartile range (IQR); error bars indicate range.

Table e-1

Triggers for spontaneous cervical artery dissection (CeAD) and ischemic stroke unrelated to cervical artery dissection (non-CeAD IS).

* In the week preceding the dissection. An infection was defined by the presence of at least one typical symptom (e.g. cough, flu-like illness, vomiting, diarrhea, purulent sputum), in combination with fever (temperature ≥ 38°C), or the presence of at least one typical symptom with

corresponding serologic, cultural, or radiologic findings indicating an acute infection, or the

combination of at least two typical corresponding symptoms.