Abstract
BackgroundCervicocephalic artery dissection (CAD) is an important etiology of stroke in the youth. Findings from recent studies suggest it a “group of disease entities” with different underlying etiologies, presentations and prognosis, necessitating an integral study including various types of CAD to get a better understanding of this disease. In addition, Chinese patients with CAD are likely to carry different features from their western counterparts, which remains uncertain yet. Chinese Cervicocephalic Artery Dissection Study (CCADS) therefore aims at exploring the epidemiology, risk factors, clinical/radiological features, diagnosis and prognosis of CAD in Chinese patients.Methods/designCCADS is a multicenter prospective cohort study enrolling patients age ≥ 18 years with recent (<14 days after onset) CAD. Baseline clinical data, laboratory tests and imaging studies are performed within 3 days after admission, and follow-ups will be conducted through face-to-face interviews at discharge, 3 months, 6 months and 12 months after admission, when the modified Rankin Scale (mRS), cerebrovascular events, medication compliance, CAD evolution and so on are evaluated. Additional blood samples will also be collected at baseline, 3 and 12 months follow-up. The primary outcome is radiographic evolution of CAD; secondary outcomes include cerebrovascular events, major bleeding complications, all-cause mortality and functional independence.DiscussionThrough the integration of information on epidemiology, risk factors, clinical/radiological features and prognosis of various types of CAD in Chinese population, combined with the application of advanced imaging techniques, collection of potential blood biomarkers, and assessment of novel treatment strategies. CCADS will provide thorough information on CAD - the major cause of stroke in the youth, and play a role in prevention and treatment determination in the future.
Highlights
Cervicocephalic artery dissection (CAD) is an important etiology of stroke in the youth
Artery Dissection and Ischemic Stroke Patients) is the largest cohort study worldwide examining different profiles according to the dissection site in ischemic stroke patients with cervical artery dissection [7], while knowledge on either milder or more severe type of CAD is lacking
We describe here the protocol of Cervicocephalic Artery Dissection Study (CCADS), a multicenter prospective cohort study to explore the epidemiology, risk factors, clinical/radiological features, diagnosis and prognosis of CAD in Chinese patients incorporating the application of advanced imaging techniques, collection of potential blood biomarkers, and assessment of novel treatment strategies
Summary
Cervicocephalic artery dissection (CAD) is an important etiology of stroke in the youth. Cervicocephalic artery dissection (CAD) is an important etiology of stroke in the youth, accounting for 8%–25% of stroke events among patients aged 18 to 49 years [2, 3]. Thanks to the CAD used to be considered a “single disease”, findings from recent studies suggest it a “group of disease entities” with various features based on different sites (intracranial vs extracranial, anterior vs posterior circulation), morphologies (intimal flap, double lumen or intramural hematoma), and presentations (isolated headache, cranial nerve palsies, ischemic stroke or subarachnoid hemorrhage) [4,5,6]. By assuming that the existence of CAD may worsen the vascular lesions in the long run when atherosclerosis develops with aging, the clinical outcomes and the radiographic evolution of CAD needs to be paid close attention to
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