Cervical Artery Dissection Recurrence in an Unselected Danish Cohort

Area of Science:

• Neurology
• Vascular Medicine
• Stroke Research

Background:

• Spontaneous cervical artery dissection (CeAD) is a significant cause of ischemic stroke in young adults.
• The underlying pathophysiology and risk factors for CeAD remain largely unknown.
• Recurrences of CeAD are traditionally considered rare, typically occurring within the first three months post-event.

Purpose of the Study:

• To investigate the incidence and timing of all recurrent dissections in an unselected patient cohort following an initial CeAD diagnosis.
• To identify risk factors associated with CeAD recurrence.
• To assess the occurrence of new stroke events after the index CeAD.

Main Methods:

• A retrospective analysis of 102 patients diagnosed with CeAD between October 2014 and December 2024.
• Review of medical records for demographics, risk factors, and treatments.
• Acquisition of imaging reports from routine follow-up and repeat admissions to determine recurrence and stroke rates.

Main Results:

• CeAD recurrence occurred in 6.9% of patients, with a significant proportion happening after six months.
• Asymptomatic recurrences accounted for 28.6% of all CeAD recurrences.
• Family history of dissection and radiologically verified tortuous cervical arteries were significantly associated with recurrence.
• Stroke occurred in 2.9% of patients, with no strokes observed in those experiencing CeAD recurrence.

Conclusions:

• Recurrence of CeAD and subsequent stroke events were infrequent after the initial diagnosis.
• CeAD recurrences can be asymptomatic and manifest later than previously documented.
• Long-term monitoring and stroke prevention strategies are crucial, particularly for patients with a family history of dissection or cervical artery tortuosity.