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Recurrence of cervical artery dissection: A systematic review and meta-analysis

Elizabeth Lounsbury1,2, Naomi Niznick1,2, Ranjeeta Mallick3

  • 1Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

International Journal of Stroke : Official Journal of the International Stroke Society
|September 4, 2023
PubMed

Insights

Recurrent cervical artery dissection (CAD) is uncommon, with overall recurrence rates at 4%. The risk of recurrent CAD associated with ischemic events is even lower, approximately 2%.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Epidemiology

Background:

  • Cervical artery dissection (CAD) is a significant cause of stroke in young individuals.
  • It involves spontaneous or traumatic tears in the carotid or vertebral arteries.
  • Understanding recurrence risk is crucial for patient management and stroke prevention.

Purpose of the Study:

  • To systematically review and meta-analyze the incidence of recurrent cervical artery dissection.
  • To quantify the risk of CAD recurrence over time.
  • To assess the rate of recurrent CAD associated with ischemic events.

Main Methods:

  • Systematic review and meta-analysis of 29 studies.
  • Inclusion of studies with radiographically confirmed extracranial carotid or vertebral artery dissections.
  • Pooling of incidence rates using random-effects models.

Main Results:

  • The overall incidence of recurrent CAD was 4% (95% CI: 3-7%).
  • Recurrence rates were 2% at 1 month and 7% at 1 year.
  • The incidence of recurrence associated with ischemic events was 2% (95% CI: 1-3%).

Conclusions:

  • Recurrent cervical artery dissection occurs at low rates.
  • Recurrence associated with ischemic events is infrequent.
  • Further patient-level data are needed for improved risk stratification.
Abstract

Keywords:
Dissectionischemic strokeoutcomerecurrence

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