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Cervical artery dissection: trauma and other potential mechanical trigger events.
Stefan T Engelter1, Caspar Grond-Ginsbach, Tiina M Metso
1Department of Neurology, Basel University Hospital, Basel, Switzerland.
Neurology
|May 3, 2013
Summary
Prior cervical trauma (PCT) is linked to cervical artery dissection (CeAD), often mild, and may act as a mechanical trigger. However, PCT did not independently predict CeAD outcomes.
Area of Science:
- Neurology
- Vascular Medicine
- Epidemiology
Background:
- Cervical artery dissection (CeAD) is a significant cause of stroke in younger adults.
- The role of prior cervical trauma (PCT) as a potential trigger for CeAD requires further investigation.
Purpose of the Study:
- To determine the association between prior cervical trauma (PCT) and the occurrence of cervical artery dissection (CeAD).
- To evaluate if PCT influences the clinical presentation and functional outcomes of CeAD patients.
Main Methods:
- An observational study comparing CeAD patients with non-CeAD ischemic stroke patients and healthy controls.
- Systematic assessment of PCT presence and type using a standardized questionnaire within one month of symptom onset.
- Statistical analysis included crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).
Main Results:
- Prior cervical trauma (PCT) was identified in 40.5% of CeAD patients, predominantly mild.
- PCT was significantly more frequent in CeAD patients compared to both non-CeAD ischemic stroke patients and healthy controls.
- CeAD patients with PCT were younger and more likely to present with neck pain than stroke.
Conclusions:
- Prior cervical trauma (PCT) appears to be a significant environmental factor contributing to cervical artery dissection (CeAD).
- The term "mechanical trigger event" may be more fitting than "trauma" given the nature of most PCTs.
- PCT was not found to be an independent predictor of functional outcomes at three months post-CeAD.
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