Recurrent versus first cervical artery dissection - a retrospective study of clinical and vascular characteristics

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Kloss , M , Kalashnikova , L , Dobrynina , L , Traenka , C , Engelter , S T , Metso , T M , Tatlisumak , T , Urbanek , C , Grau , A , Kellert , L , Brandt , T , Wieker , C M , Grond-Ginsbach , C & Pezzini , A 2020 , ' Recurrent versus first cervical artery dissection - a retrospective study of clinical and vascular characteristics ' , European Journal of Neurology , vol. 27 , no. 11 , pp. 2185-2190 . https://doi.org/10.1111/ene.14417

Title: Recurrent versus first cervical artery dissection - a retrospective study of clinical and vascular characteristics
Author: Kloss, M.; Kalashnikova, L.; Dobrynina, L.; Traenka, C.; Engelter, S. T.; Metso, T. M.; Tatlisumak, T.; Urbanek, C.; Grau, A.; Kellert, L.; Brandt, T.; Wieker, C. M.; Grond-Ginsbach, C.; Pezzini, A.
Contributor: University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Neurocenter
Date: 2020-11
Language: eng
Number of pages: 6
Belongs to series: European Journal of Neurology
ISSN: 1351-5101
URI: http://hdl.handle.net/10138/332516
Abstract: Background and purpose Most recurrent cervical artery dissection (CeAD) events occur shortly after the acute first CeAD. This study compared the characteristics of recurrent and first CeAD events and searched for associations between subsequent events of an individual person. Methods Cervical artery dissection patients with a new CeAD event occurring during a 3-6 month follow-up were retrospectively selected in seven specialized stroke centers. Clinical and vascular characteristics of the initial and the recurrent CeADs were compared. Results The study sample included 76 patients. Recurrent CeADs were occlusive in one (1.3%) patient, caused cerebral ischaemia in 13 (17.1%) and were asymptomatic in 39 (51.3%) patients, compared to 29 (38.2%) occlusive, 42 (55.3%) ischaemic and no asymptomatic first CeAD events. In 52 (68.4%) patients, recurrent dissections affected both internal carotid arteries or both vertebral arteries, whilst 24 (31.6%) patients had subsequent dissections in both types of artery. Twelve (28.6%) of 42 patients with an ischaemic first dissection had ischaemic symptoms due to the recurrent CeADs, too. However, only one (1.3%) of 34 patients with a non-ischaemic first CeAD suffered ischaemia upon recurrence. Conclusion Recurrent CeAD typically affects the same site of artery. It causes ischaemic events less often than the first CeAD. The risk that patients who presented with solely non-ischaemic symptoms of a first CeAD will have ischaemic symptoms in the case of a recurrent CeAD seems very small.
Subject: arterial dissection
epidemiology
cerebrovascular diseases and cerebral circulation
cerebral infarction
STROKE
ENDARTERECTOMY
RISK
3112 Neurosciences
3124 Neurology and psychiatry
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