Abstract

Background and Aims: Spontaneous cervical artery dissection (CeAD) broad clinical spectrum includes none or minor local signs to severe stroke. Men predominance has been described, with most infor- mation coming from European and US tertiary academic centers. Aim: Characterize CeAD patients with and without central nervous system manifestations, and describe risk factors for stroke in a CeAD Chilean prospective cohort. Methods: consecutive patients between 2011 and 2018 with CeAD neuroimaging confirmation were included. Uni and multivariate logistic regression was performed. P value £0.05 was considered significant. Results: in 168 patients, mean age was 41 (SD 9.2) years, 67 (39.9%) were men and mean follow-up time was 256 days. Stroke occurred in 49 (29.2%). Four (2%) patients died, all of whom had a stroke, and ten (6%) presented CeAD recurrence. In univariate analysis, men (odds ratio [OR] 3.97, 95% confidence interval [CI] 1.97-8.00, P < 0.001), internal carotid artery CeAD (OR 2.82, 95% CI 1.38-5.78, P 1⁄4 0.005) and vessel occlu- sion (OR 4.45, 95% CI 1.38-14.38, P1⁄40.035) increased stroke risk. Conversely, vertebral artery dissection (OR 0.35, 95% CI 0.16-0.74, P1⁄40.006) and symptoms onset to admission (O-A) time (OR 0.79, 95% CI 0.70-0.90, P < 0.001) reduced stroke risk. After multivariate anal- ysis, men (OR 2.88, 95% CI 1.32-6.27, P < 0.001) and O-A time (OR 0.80, 95% CI 0.69-0.92, P 1⁄4 0.002) remained independently associated with stroke. Conclusions: CeAD presented commonly as a non-stroke entity, with favorable prognosis. Albeit to a higher frequency of CeAD in women, stroke occurred predominantly in men, early after symptom onset. In this population the gender distribution warrants further research.