Cervical Artery Dissections with and without stroke, risk factors and prognosis: a Chilean prospective cohort

Mazzon, Enrico; Rocha, Diego; Brunser, Alejandro; De La Barra, Camila; Stecher, Ximena; Bernstein, Tomás; Zúñiga, Paulo; Díaz, Violeta; Martínez, Gonzalo; Muñoz-Venturelli, Paula

Keywords: Carotid artery dissection, Vertebral artery dissection, Cervical artery dissection, Stroke, Risk factors, Cohort


We aimed to characterize spontaneous cervical artery dissection (CeAD) patients with and without stroke and describe risk factors for cerebrovascular complications in a Chilean prospective cohort. Methods: Consecutive CeAD patients admitted to a Chilean center confirmed by neuroimaging. Logistic regression was used. Results: 168 patients were included, median follow-up time was 157 days. Stroke occurred in 49 (29.2%) cases, 4 (2%) patients died, all of whom had a stroke, and 10 (6%) presented CeAD recurrence. In univariate analyses, 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 = 0.005) and vessel occlusion (OR 4.45, 95% CI 1.38–14.38, P = 0.035) increased stroke risk. Conversely, vertebral artery dissection (OR 0.35, 95% CI 0.16–0.74, P = 0.006) and longer symptom onset to admission (O–A) time (OR 0.79, 95% CI 0.70–0.90, P < 0.001) were associated to decreased stroke risk. After multivariate analysis, men (OR 2.88, 95% CI 1.32-6.27, P = 0.008) and O–A time (OR 0.80, 95% CI 0.69–0.92, P = 0.002) remained independently associated with stroke. Conclusion: 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, who were admitted earlier.

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Volumen: 29
Número: 8
Editorial: Elsevier
Fecha de publicación: 2020
Idioma: Ingles
Notas: DOI:https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104992