Long-term outcome of cervical artery dissection

Area of Science:

• Neurology
• Vascular Surgery
• Radiology

Background:

• Extracranial cervical artery dissection (CAD) is a significant cause of stroke in younger adults.
• Understanding its natural history and treatment outcomes is crucial for patient management.

Purpose of the Study:

• To evaluate the natural history of extracranial cervical artery dissection (CAD).
• To analyze comorbidities, presenting symptoms, recurrence, and long-term outcomes.
• To assess different treatment approaches for CAD.

Main Methods:

• Retrospective review of patients treated for acute CAD from January 2017 to April 2022.
• Inclusion of 39 patients with internal carotid or vertebral artery dissection.
• Analysis of clinical presentation, imaging, treatment, and follow-up data.

Main Results:

• Most dissections were spontaneous (87.1%).
• Common symptoms included unilateral weakness, headache, and slurred speech.
• Conservative management (anticoagulation/antiplatelets) led to symptom resolution in 90.9% and anatomical resolution in 76.47% of followed patients.
• Low recurrence rates (four early events) were observed.

Conclusions:

• The majority of extracranial cervical artery dissections (CAD) can be managed conservatively.
• Good clinical and anatomical outcomes are achievable with low recurrence rates.
• Conservative treatment appears effective for managing CAD.