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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
PubMed

Insights

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.
Abstract

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