Stroke occurrence and patterns are not influenced by the degree of stenosis in cervical artery dissection

In stroke attributable to spontaneous dissection of the cervical artery, it is unclear whether the occurrence and pattern of stroke depend on the degree of stenosis.

In 147 consecutive dissection of the cervical artery patients with (n=88) and without stroke (n=59), we compared the number, volume, and patterns of cerebral diffusion-weighted imaging stroke lesions among patients with <70% stenosis (Group 1), ≥70% stenosis (Group 2), and occlusion (Group 3).

The presence (26 of 45 in Group 1, 32 of 59 in Group 2, 30 of 43 in Group 3; P=0.27) and the number of diffusion-weighted imaging lesions (mean±SD [interquartile range], 3.5±3.9 [1-4] in Group 1; 4.2±4.1 [1-5] in Group 2; 3.3±4.0 [1-3] in Group 3; P=0.85) were independent of lumen patency, whereas volume of diffusion-weighted imaging lesions was larger in occlusive dissection of the cervical artery (82±90 mm [17-91] versus 34±54 [2-48]; P=0.03). There were no differences in the breakdown of diffusion-weighted imaging lesion patterns according to degree of stenosis.

The occurrence and diffusion-weighted imaging lesion patterns in dissection of the cervical artery patients may not be influenced by the degree of stenosis of the dissected artery. Occlusive dissection of the cervical artery was associated with larger infarcts.