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Cervical artery dissection: risk factors, treatment, and outcome; a 5-year experience from a tertiary care center

Shadi Yaghi1, Nancy Maalouf, Salah G Keyrouz

  • 1Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, USA. shadiyaghi@yahoo.com

The International Journal of Neuroscience
|September 13, 2011
PubMed

Insights

Cervical artery dissection (CAD) is a common cause of stroke in young people. Hypertension and high cholesterol are risk factors for spontaneous CAD, with no clear treatment advantage between anticoagulation and antiplatelet therapy.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Epidemiology

Background:

  • Cervical artery dissection (CAD) is a significant cause of stroke in young adults.
  • Established risk factors, optimal treatments, and patient outcomes for CAD remain incompletely understood.
  • This study aimed to elucidate risk factors, treatment strategies, and outcomes associated with CAD.

Purpose of the Study:

  • To identify key risk factors associated with cervical artery dissection (CAD).
  • To evaluate the treatment modalities and patient outcomes following CAD.
  • To investigate the underlying pathophysiology contributing to CAD.

Main Methods:

  • Retrospective review of medical records for patients diagnosed with CAD between 2004 and 2009.
  • Utilized ICD-9 codes to identify cases and extract data on risk factors, treatment, and outcomes.
  • Defined poor outcome as a modified Rankin Scale (mRS) score >1, recurrent stroke, or transient ischemic attack (TIA) within 6 months.

Main Results:

  • 47 patients with CAD were identified; 52% had spontaneous dissections, and 63% involved the carotid artery.
  • Spontaneous dissections were linked to hypertension (63%) and hypercholesterolemia (46%), suggesting vascular wall abnormalities.
  • Traumatic dissections occurred in younger patients and were more likely to involve the vertebral artery; no significant difference in outcomes was observed between anticoagulation and antiplatelet treatments.

Conclusions:

  • Hypertension and hypercholesterolemia are identified as risk factors for spontaneous cervical artery dissection (CAD).
  • Current evidence does not support a superior treatment approach between anticoagulation and antiplatelet therapy for CAD.
  • Further large-scale prospective studies are warranted to resolve treatment controversies in CAD management.
Abstract

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