Dissection of cervical arteries: Long-term follow-up study of 130 consecutive cases

Antonio Arauz, Leticia Hoyos, Carlos Espinoza, Carlos Cantú, Fernando Barinagarrementeria, Gustavo C. Roman

Research output: Contribution to journalArticle

84 Scopus citations

Abstract

Background and Purpose: We describe the natural history, functional prognosis and long-term recurrences of patients with dissection of cervical arteries (DCA) in a sequential observational study. Methods: We describe 130 patients with angiographically-proven DCA admitted to the Neurology Institute in Mexico City (Mexico), and analyzed clinical and neuroimaging data, treatment and outcome. Treatment with either anticoagulation or aspirin was decided by the primary physician. Primary outcome measures were recurrence (stroke and death) and clinical outcome at 6 months. Follow-up studies were performed to determine recanalization. Results: Mean age was 35.4 years; 4 patients died (3%) and 126 were followed for 3,906 person/years; 17 patients (13%) had a heralding ischemic cerebral event (6 strokes, 11 TIAS) about 8 days before the diagnosis of DCA. After diagnosis, recurrent ischemic stroke occurred in 6 patients (4.8%) within the 2 first weeks (1.5 persons/1,000 follow-up years). No significant differences were found between aspirin and anticoagulation. Recanalization was more frequent in vertebral dissections. Complete recanalization of vertebral dissections was associated with a favorable prognosis [OR 3.2 (95% CI 1.1-8.8; p = 0.02)]. Conclusions: In Mexico, DCA affects young adults and may present with a heralding stroke or TIA. We found rare, early ischemic recurrences. Vertebral territory dissections had better prognosis than carotid ones, particularly in patients with demonstrated complete recanalization.

Original languageEnglish (US)
Pages (from-to)150-154
Number of pages5
JournalCerebrovascular Diseases
Volume22
Issue number2-3
DOIs
StatePublished - Jul 1 2006

Keywords

  • Anticoagulation
  • Aspirin
  • Dissection of cervical arteries

ASJC Scopus subject areas

  • Clinical Neurology

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