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

Abstract

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.