Long-term outcome of cervical artery dissection

Janquli, Mohammed; Selvarajah, Logeswaran; Moloney, Michael A.; Kavanagh, Eamon G.; O’Neill, Damien Christopher; Medani, Mekki

doi:10.1016/j.jvs.2023.03.020

Cited by 3 publications

(1 citation statement)

References 45 publications

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“…Our study found that clinical outcomes were favorable (mRS 0-2) in most patients, and mortality was low. These results are consistent with those of a series of reports on patients with spontaneous sVAD and sICAD [17][18][19][20] .…”

Section: Discussionsupporting

confidence: 93%

The clinical characteristics and predictors of patients with ischemic stroke caused by spontaneous internal carotid artery dissection

Zhong,

Li,

et al. 2023

Preprint

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Background: Few studies have examined the clinical characteristics and predictors of ischemic stroke caused by spontaneous internal carotid artery dissection (sICAD). This study aimed to investigate the clinical characteristics and predictors of patients with ischemic stroke caused by sICAD to provide clinical guidance and a basis for treatment. Methods: Clinical characteristics, outcomes, and predictors were investigated in consecutive patients with ischemic stroke caused by sICAD between January 2018 and January 2022 at Three Grade III Class A general public hospitals in southwest China. We screened 102 patients with ischemic stroke caused by ICAD for follow-up, of which 11 were lost to follow-up. Results: Of the 91 patients included in this study, 84 had unilateral and seven had bilateral stroke, with a mean follow-up modified Rankin Scale (mRS) score of 1(0-3). Sixty-six (72.5%) of the 91 patients had mRS scores of 0-2. On multivariate analysis, low baseline National Institutes of Health Stroke Scale (NIHSS) scores (P ＜ 0.01; odds ratio [OR]: 1.39; 95% confidence interval [CI]: 1.12–1.73) and endovascular stenting (P ＜ 0.01; OR: 0.10; 95% CI: 0.02–0.50) were independent predictors of a favorable clinical outcome. Receiver operating characteristic (ROC) analysis showed an area under the curve of 0.94. Conclusions: Favorable outcomes were observed in majority of patients with ischemic stroke caused by sICAD. Additionally, lower NIHSS scores and stent implantation were independent predictors of favorable outcomes.

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Section: Discussionsupporting

confidence: 93%

The clinical characteristics and predictors of patients with ischemic stroke caused by spontaneous internal carotid artery dissection

Zhong,

Li,

et al. 2023

Preprint

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Individual participant data analysis comparing acute stroke patients with anterior versus posterior circulation dissections

Zhang,

Froehlich

et al. 2024

Clinical Neurology and Neurosurgery

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Are There Differences between Traumatic and Spontaneous Cervical Artery Dissections?

Metanis,

Simaan,

Schwartzmann

et al. 2024

JCM

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(1) Background: Cervical arterial dissections (CeAD) are a common cause of stroke in young adults. CeAD can be spontaneous (sCeAD) or traumatic (tCeAD). Whether CeAD subtypes differ in clinical, radiological, and outcome characteristics remains unexplored. (2) Methods: Patients with CeAD were identified and divided between sCeAD and tCeAD. Demographics, clinical features, risk factors, imaging findings, treatments, and outcomes were compared between the groups. Logistic regressions were used to determine characteristics associated with favorable outcome. (3) Results: Overall, 154 patients were included (106 sCeAD and 48 tCeAD). Patients with sCeAD were significantly older (mean ± SD 46 ± 12 vs. 35 ± 14, p < 0.001) and were more likely to have hyperlipidemia (19% vs. 4%, p = 0.016), but other risk factors did not differ. Patients with tCeAD less often had signs of early infarction on imaging (21% vs. 49%, p = 0.001) and had lower stroke severity on admission (NIHSS, median, interquartile range [IQR] 0 (0–9) vs. 2 (0–4), p = 0.012), but more often had symptomatic intracranial hemorrhages (12.5% vs. 2%, p = 0.006). Patients with tCeAD less often had favorable outcomes at 90 days (78% vs. 97%, p < 0.001). In the regression analysis, the only variables associated with favorable outcome were age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.03–1.24), initial stroke severity (OR 0.84, 95% CI 0.73–0.97), degree of vessel stenosis (OR 0.35, 95% CI 0.14–0.83), and involvement of multiple vessels on presentation (OR 0.04, 95% CI 0.02–0.70), whereas dissection subtype was not associated (OR 0.45, 95% CI 0.03–68.80). (4) Conclusions: Dissection subtype is not an independent modifier of the chances of attaining functional independence.

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Long-term outcome of cervical artery dissection

Cited by 3 publications

References 45 publications

The clinical characteristics and predictors of patients with ischemic stroke caused by spontaneous internal carotid artery dissection

The clinical characteristics and predictors of patients with ischemic stroke caused by spontaneous internal carotid artery dissection

Individual participant data analysis comparing acute stroke patients with anterior versus posterior circulation dissections

Are There Differences between Traumatic and Spontaneous Cervical Artery Dissections?

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