Internal carotid artery dissection among younger and older patients with acute ischemic stroke

Area of Science:

• Neurology
• Vascular Medicine
• Radiology

Background:

• Carotid artery dissection (CAD) is a recognized cause of ischemic stroke, particularly in younger individuals.
• The role of CAD in older acute ischemic stroke patients remains less understood.
• Prior studies have limited data on CAD's independent contribution in diverse populations.

Purpose of the Study:

• To determine the significance of carotid artery dissection (CAD) as an independent factor in acute ischemic stroke (AIS) among older patients.
• To analyze the association between CAD and common covariables in AIS patients.
• To evaluate the prevalence and impact of CAD in a northern Israeli cohort.

Main Methods:

• A retrospective review of 347 consecutive acute ischemic stroke patients was conducted.
• CT angiography (CTA) was used to identify radiologic signs of carotid artery dissection (CAD).
• Demographic and clinical data were collected from hospital records for multivariate analysis.

Main Results:

• Carotid artery dissection (CAD) was identified in 5.19% of the 347 acute ischemic stroke patients via CTA.
• No significant differences in CAD prevalence were observed based on age, gender, or ethnicity.
• Hypertension showed a significant inverse association with CAD, while hyperlipidemia trended similarly.

Conclusions:

• Carotid artery dissection (CAD) is confirmed as an independent and significant etiological factor for acute ischemic stroke.
• Diagnostic imaging to rule out CAD should be considered for all acute ischemic stroke patients, not exclusively younger individuals.
• The inverse correlation with hypertension and hyperlipidemia suggests CAD is a nonatherosclerotic cause of stroke.