Carotid Artery Dissection Research Articles

Acute ischemic stroke revealing an internal carotid artery dissection in a 12-year-old child: case report and literature review

Introduction and importance: Internal carotid artery (ICA) dissection is a known cause of stroke but is often underdiagnosed in pediatric patients. Pediatric ischemic stroke significantly contributes to juvenile brain injury. Currently, there are no universally accepted guidelines for managing stroke in children. Case Presentation: We report the case of a 12-year-old girl who was admitted with sudden left hemiplegia and aphasia. Imaging revealed right carotid artery dissection and ischemic stroke in the right middle cerebral artery territory. She was managed with aspirin (75 mg/day) and enoxaparin (3000 IU/12 h) and remains under observation with persistent symptoms. Clinical discussion: This case highlights the difficulty in diagnosing ICA dissections in pediatric patients and the lack of clear guidelines for their management. The use of aspirin and enoxaparin represents an empirically-based therapeutic approach, underscoring the urgent need for further research to better understand the risk factors and pathogenic mechanisms of this condition. The persistence of symptoms in our patient also emphasizes the importance of close monitoring and individualized management. Conclusion: ICA dissection in pediatric stroke is hard to diagnose and treat. Research, empirically-based treatments, and personalized monitoring are crucial for better management and outcomes.

Establishment and evaluation of a carotid artery dissection model in rats

BackgroundGiven the lack of models for carotid artery dissections (CAD), we aim to investigate effects of beta-aminopropionitrile (BAPN) combined with physical damage on the arterial walls of rats, and to establish a high-incidence and low-mortality CAD model.MethodsSixteen SPF SD rats (3-week-old) were divided into two groups. Group B was given 0.25% BAPN solution and group W was given water. Then we established an animal model of CAD by carotid artery torsion. One of the two carotid arteries in each rat was randomly selected for torsion. We got four groups of blood vessels following above-mentioned methods: BAPN plus torsion group (group Bt), BAPN plus non-torsion group (group Bn), water plus torsion group (group Wt), and water plus non-torsion group (group Wn). The hematoxylin and eosin (HE) staining and Verhoeff’s Van Gieson (EVG) staining were performed to observe structures of arteries. Immunofluorescence staining was used to detect structural proteins in vessels. We used triphenyltetrazolium chloride (TTC) staining and neurological function assessment to detect the infarct area of brain and neurological deficits in rats with carotid dissection to verify the validity of the rat model.ResultsBAPN treatment significantly affected the weight gain of rats, but had little effect on survival during the first 5 weeks. The group Bt had the highest incidence of CAD among all groups (p = 0.014). HE staining of carotid artery tissue sections showed that the vascular walls were the thickest in group Bt (p < 0.001). EVG staining showed the arrangement of elastic fibers was the most irregular in group Bt. Immunofluorescence staining revealed that the expression of a-SMA and SM22a were decreased remarkably in group Bt (p < 0.001). Both motor and sensory deficits were more severe in CAD group than control group (p = 0.0004; p = 0.0036). The relative infarction volumes of CAD group rats were significantly larger than control group (p < 0.001).ConclusionThe animal model of CAD can be feasible to establish by mechanical torsion combined with BAPN free drinking. With this method, the animal mortality was low and the model formation rate was high. This model will enable further studies on CAD.

False Lumen Stenting to the Acute Occlusive Carotid Artery Dissection Combined With Intracranial Acute Embolic Stroke: A Case Report and Literature Review

False Lumen Stenting to the Acute Occlusive Carotid Artery Dissection Combined With Intracranial Acute Embolic Stroke: A Case Report and Literature Review

Differential Outcomes and Treatment in Non-traumatic Carotid versus Vertebral Cervical Artery Dissection: A National Inpatient Sample Study.

Cervical artery dissection (CAD) involves the carotid or vertebral artery. However, limited studies have compared their clinical features and outcomes. We examined non-traumatic CAD patients from the National Inpatient Sample (2005-2019). Those diagnosed with both carotid and vertebral artery dissections were excluded. The evaluation included patient demographics, comorbidities, and treatment. Differences between carotid and vertebral dissections were assessed using survey-weighted stepwise backward logistic regression, followed by adjusted multivariable regressions for the primary outcomes of in-hospital mortality and routine discharge (to home or self-care). From 2005 to 2019, we included 123,224 non-traumatic CAD admissions without concurrent vertebral and carotid dissections. There were more carotid dissections than vertebral dissections (67,533 vs. 55,691). Compared to vertebral dissection, carotid dissection was associated with older age (54 [44-66] years vs. 49 [37-62] years, P<0.001), Black race (12.6% vs. 8.8%, P<0.001), White race (73.5% vs. 72.0%, P = 0.024), atrial fibrillation (10.8% vs. 6.3%, P<0.001), aortic dissection (7.7% vs. 0.3%, P<0.001), and fewer concurrent acute ischemic strokes (AIS) (47.8% vs. 56.7%, P<0.001).Within the concurrent AIS group, carotid CAD patients exhibited higher NIHSS (8 [2-17] vs. 2 [0-5], P<0.001), an increased utilization of intravenous thrombolysis (6.7% vs. 2.7% P<0.001), endovascular therapy (13.3% vs. 3.3%, P<0.001), and angioplasties (9.8% vs. 0.3%, P<0.001). Overall, carotid CAD was associated with more inpatient deaths (aOR 1.30, 95% CI 1.04-1.62, P=0.023) and less routine discharges (aOR 0.88, 95% CI 0.79-0.97, P=0.014) than vertebral CAD. Our study underscores distinct comorbidity profiles and treatment patterns between non-traumatic carotid dissection and vertebral dissection groups. These findings advocate for tailored treatment strategies based on dissection type to optimize patient outcomes.

Percutaneous Carotid Access in Endovascular Aortic Arch Repair: Initial Experience.

Direct percutaneous access to the carotid artery (diPerCa) during endovascular aortic arch repair (EVAAR) can potentially present a minimally invasive access with lesser local adverse events. A retrospective review of consecutive EVAAR between January 2018 and January 2024, in a tertiary referral center, was performed to identify cases, in which diPerCa was used. Patients who were planned for EVAAR with no previous carotid intervention were included. A standardized technique was employed where an ultrasound-guided retrograde puncture of the carotid artery was performed with a micro-puncture set and a suture-mediated closure device (pre-closure technique). Of the 13 included patients, technical success was achieved in 12 (92.3%), with one intraoperative death unrelated to diPerCa. Major complications included one case of carotid pseudoaneurysm and one case of non-flow-limiting carotid dissection. Minor complications were unilateral recurrent laryngeal nerve palsy in one case and new-onset dizziness in one case. All carotid arteries remained patent without stenosis, with one case of non-progressing dissection noted at the conclusion of the mean follow-up of 22.5±2.4 months. Direct percutaneous carotid access with suture-mediated closure devices during EVAAR is feasible with acceptable results and low incidence of clinically relevant neurological and local complications. Further studies are needed to confirm these findings and evaluate long-term outcomes. Direct percutaneous carotid access (diPerCa) during endovascular aortic arch repair (EVAAR) offers a minimally invasive alternative to retrograde access via open surgical exposure. This technique, supported by suture-based closure devices, demonstrates no stroke and low rates of local complications. Overall outcomes are promising, suggesting diPerCa as a feasible option for select patients. Further research is warranted to validate these findings and assess long-term outcomes.

An unexpected variation of occipital and ascending pharyngeal arteries: clinical implications

PurposeThe eight typical External Carotid Artery (ECA) branches are the superior thyroid artery, ascending pharyngeal artery, lingual artery, facial artery, occipital artery, posterior auricular artery, maxillary artery, and superficial temporal artery. The Internal Carotid Artery (ICA) has no branches in the cervical region before entering the carotid canal. We identified a variant of the Occipital Artery (OA) and Ascending Pharyngeal Artery (APA) originating in the cervical portion of the ICA and wish to explore the clinical implications this variation may have.MethodsBetween August and December 2023, 28 formaldehyde donors were dissected in the anatomy course for first-year medical and physician assistant students at the Creighton University School of Medicine, Phoenix campus.ResultsIn one donor, dissection of the right common carotid artery (CCA) revealed a variation of the ECA branches. Two branches were found on the proximal portion of the ICA. After tracing the branches cranially, we identified these as the OA and APA. These two arteries typically originate from the ECA. The bifurcation angle was observed to be nearly 180 degrees. This variation was only observed on the right side.ConclusionAs the prevalence of this variation has only been described in one study, reporting at 0.14%, documentation and education of this anatomy aids surgeons and interventional radiologists in head and neck procedures. Exploring the paths of these ectopic arteries promotes informed decision making and risk stratification for carotid endarterectomy, arterial embolization, bypass procedures, and arterial harvesting. Furthermore, performing thorough imaging such as CT angiograms on patients preoperatively provides better foresight to minimize complications.

Revascularization with superficial temporal artery-middle cerebral artery anastomosis in spontaneous intracranial internal carotid artery dissection: illustrative case.

Because of ischemic symptoms, intracranial internal carotid artery (IICA) dissection has no established treatment guidelines. The authors report a case of IICA dissection in which an emergency superficial temporal artery-middle cerebral artery (STA-MCA) bypass was performed. A 46-year-old woman presented with a headache and left hemiplegia. Her cortical symptoms appeared on day 10, and an STA-MCA bypass was performed because of cerebral hypoperfusion. Her postoperative patency was good, and cortical symptoms improved. Contrast-enhanced magnetic resonance imaging (MRI) was performed in the acute phase with wall contrast. From day 18, the internal carotid artery delineation improved, and the patient was transferred for rehabilitation without worsening symptoms. A literature review of spontaneous IICA dissection with revascularization procedures was conducted to discuss the indications, timing, treatment modalities, and surgical outcomes. The STA-MCA bypass provides supplemental cerebral blood flow and can prevent critical complications. Contrast-enhanced MRI in the acute phase of dissection can show a wall contrast effect and assist in predicting disease progression. https://thejns.org/doi/10.3171/CASE24332.

Antithrombotic drugs for carotid artery dissection: Updated systematic review.

Extracranial internal carotid artery dissection (eICAD) is a leading cause of stroke in younger patients. In this Cochrane Review update we compared benefits and harms of eICAD-patients treated with either antiplatelets or anticoagulants. Eligible studies were identified through Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, and EMBASE and personal search until December 2023. We included randomized-controlled trials (RCTs) and non-randomized studies comparing anticoagulants with antiplatelets in eICAD-patients. Co-primary outcomes were (i) death (all causes) and (ii) death or disability. Secondary outcomes were ischemic stroke, symptomatic intracranial hemorrhage, and major extracranial hemorrhage. Odds ratios (OR) with 95% CIs were calculated for (i) all studies and (ii) separately for RCTs and non-randomized studies. We meta-analyzed a total of 42 studies (2624 patients) including 2 RCTs (213 patients) for the primary outcome of death and 31 studies (1953 patients) including 1 RCT (115 patients) for the primary outcome of death or disability. Antiplatelet-treated patients had higher odds for death (ORall-studies 2.70, 95% CI 1.27-5.72; ORRTCs 6.80, 95% CI 0.14-345; ORnon-randomized studies 2.60, 95% CI 1.20-5.60) and death or disability (ORall-studies 2.1, 95% CI 1.58-2.66; ORRTCs 2.2, 95% CI 0.29-16.05; ORnon-randomized studies 2.1, 95% CI 1.58-2.66) than anticoagulated patients. Antiplatelet-treated patients had also higher odds for ischemic stroke, though this reached statistical significance only in the subgroup of RCTs (ORRTC 4.60, 95% CI 1.36-15.51). In turn, antiplatelet-treated patients had less symptomatic intracranial hemorrhage (ORall-studies 0.25, 95% CI 0.07-0.86) and a tendency toward less major extracranial hemorrhage (ORall-studies 0.17, 95% CI 0.03-1.03). The evidence considering antiplatelets as standard of care in eICAD is weak. Individualized treatment decisions balancing risks versus harms seem recommendable.

Transient global amnesia in a patient with painless spontaneous internal carotid artery dissection: An unusual but possible underlying cause

he Article Abstract is not available.

Left, Then Right ICA Dissection: A Case Report

ABSTRACT IntroductionWe present a unique case report of a patient who presented to the emergency departmentwith stroke-like symptoms found to have a spontaneous left sided internal carotid arterydissection. Case ReportThe patient was treated successfully with thrombectomy, and subsequently developedcontralateral symptoms caused by a right sided internal carotid artery dissection. This wasmanaged with a second contralateral thrombectomy. The patient’s course was complicated bypersistent and mild hypotension, postulated to be secondary to bilateral carotid baroreceptortrauma from the dissections. ConclusionThis case highlights the importance of close neurological monitoring for patients,preferably in a neurologic critical care setting, during and after invasive treatments such assystemic thrombolytic administration or mechanical thrombectomy, as identifying the patient’ssubsequent development of contralateral symptoms in a timely fashion was key to his positive outcome. An additional factor which had a positive impact on this outcome was the use of the RAPID Artificial Intelligence software which assists in determining whether thrombectomy maybe indicated prior to receiving a formal radiologist read on CT angiography/perfusion studies. AI technologies such as this have a great potential to augment and expedite patient care.

Patterns of Arterial Wall Lesions in Eagle Syndrome: Case Series and Literature Review.

Background: Impingement of an elongated styloid process (ESP) or calcified stylohyoid ligament on surrounding neck structures defines Eagle syndrome. The vascular variant, also called stylocarotid syndrome, results from impingement of vascular structures and remains poorly known among physicians. Research Design: We report our own experience and review the literature in order to clarify the diagnostic and therapeutic management. Patients with vascular events in relation to an ESP and hospitalized at our institution were extracted from our databank and retrospectively reviewed. We also performed a comprehensive review of the literature on Eagle syndrome using PubMed®and Google Scholar, analysing the presentation, management, and follow-up. Results: We report five cases of the vascular variant of Eagle syndrome: one carotid perforation, one focal arteriopathy, one with both acute and chronic dissection and two acute internal carotid dissection. Vascular compression, whether permanent or transient, is also reported in the literature. Management varies, although styloidectomy is deemed appropriate for symptomatic compression, while stenting is preferred in cases of perforation. Conclusions:A common definition of Eagle syndrome is required for better diagnosis and management. The choice of styloidectomy is understandable for compression but remains to be investigated in other cases.

Super Learner Algorithm for Carotid Artery Disease Diagnosis: A Machine Learning Approach Leveraging Craniocervical CT Angiography.

This study introduces a machine learning (ML) approach to diagnosing carotid artery diseases, including stenosis, aneurysm, and dissection, by leveraging craniocervical computed tomography angiography (CTA) data. A meticulously curated, balanced dataset of 122 patient cases was used, ensuring reproducibility and data quality, and this is publicly accessible at (insert dataset location). The proposed method integrates a super learner model which combines adaptive boosting, gradient boosting, and random forests algorithms, achieving an accuracy of 90%. To enhance model robustness and generalization, techniques such as k-fold cross-validation, bootstrapping, data augmentation, and the synthetic minority oversampling technique (SMOTE) were applied, expanding the dataset to 1000 instances and significantly improving performance for minority classes like aneurysm and dissection. The results highlight the pivotal role of blood vessel structural analysis in diagnosing carotid artery diseases and demonstrate the superior performance of the super learner model in comparison with state-of-the-art (SOTA) methods in terms of both accuracy and robustness. This manuscript outlines the methodology, compares the results with state-of-the-art approaches, and provides insights for future research directions in applying machine learning to medical diagnostics.

Convexity subarachnoid hemorrhage revealed contralateral internal carotid artery dissection due to Eagle syndrome: a case report

BackgroundAtraumatic localized convexity subarachnoid hemorrhage (cSAH) is an uncommon form of nonaneurysmal subarachnoid hemorrhage characterized by bleeding limited to the cerebral convexities. Ipsilateral cSAH can result from a variety of causes, such as internal carotid artery stenosis, obstruction, and dissection, although concomitant contralateral cSAH is exceptionally rare. In this case, the initial findings of cSAH led us to discovering contralateral internal carotid artery dissection (ICAD) and an elongated styloid process (ESP). ESP is recognized as a risk factor for ICAD, which is a hallmark of Eagle syndrome. This sequence of findings led to the diagnosis of Eagle syndrome, illustrating a complex and intriguing interplay between cerebrovascular conditions and anatomical variations.Case presentationA 47-year-old Japanese woman experienced acute onset of headache radiating to her neck, reaching its zenith approximately two hours after onset. Given the intractable nature of the headache and its persistence for three days, she presented to the emergency department. Neurological examination revealed no abnormalities, and the coagulation screening parameters were within normal ranges. Brain computed tomography (CT) revealed right parietal cSAH, while CT angiography (CTA) revealed ICAD and an ESP measuring 30.1 mm on the left side, positioned only 1.4 mm from the dissected artery. The unusual occurrence of contralateral cSAH prompted extensive and repeated imaging reviews that excluded reversible cerebral vasoconstriction syndrome (RCVS), leading to a diagnosis of left ICAD secondary to Eagle syndrome. The patient underwent conservative management, and the dissected ICA spontaneously resolved. The patient has remained recurrence-free for two and a half years.ConclusionsManaging cSAH requires diligent investigation for ICAD, extending beyond its identification to explore underlying causes. Recognizing Eagle syndrome, though rare, as a potential etiology of ICAD necessitates the importance of evaluating ESPs. The method for preventing recurrent cervical artery dissection due to Eagle syndrome is controversial; however, conservative management is a viable option.

Vascular variant of Eagle syndrome: a review.

Eagle syndrome is defined as an elongated styloid process (ESP) that compresses nearby vasculo-nervous structures. The vascular variant of Eagle syndrome can lead to neurological symptoms including syncope, transient ischemic attack, or stroke; however, it has also been associated with other atypical presentations, making its diagnosis challenging. This review aimed to depict the characteristics of patients with the symptomatic vascular variant of Eagle syndrome. The literature search identified 56 reported cases of vascular variants of Eagle syndrome, with a mean age at onset of 51 years (range: 15-85 years), and the male-to-female ratio was 2:4. The ESP was bilateral in 63% of the cases, and the mean length was 48 mm (range: 31-77 mm). Vascular complications were mostly represented by internal jugular vein (IVJ) stenosis (n = 28), followed by internal carotid artery (ICA) dissection (n = 15). Additionally, eight cases of ICA thrombosis and two cases of severe chronic stenosis of the ICA > 90% were reported. Vascular complications may lead to cerebral ischemia due to either a thromboembolic mechanism or, less frequently, reduced blood flow. Laminar cortical necrosis, as a cerebral complication of ICA compression, was exceptionally described in one case, and such an atypical clinical presentation may be regarded as a diagnostic pitfall.

Comparative outcomes of surgical and conservative management in carotid artery dissection.

Carotid artery dissection (CAD) is a significant cause of strokes in young individuals, leading to severe complications and socioeconomic burdens. Despite antithrombotic therapy being the primary management strategy, optimal treatment for patients with recurrent or worsening symptoms remains undefined. This study aims to describe the characteristics and evaluate the outcomes of conservative versus surgical management in CAD patients. A total of 23 patients presenting with CAD from November 2014 to December 2021 were reviewed retrospectively. Patient demographics, vascular risk factors, symptoms, imaging results, treatment details, and follow-up information were collected and analyzed. Propensity score matching (PSM) was utilized to enhance comparability. The mean age of the patients was 46.4 ± 9.4 years, with a median follow-up of 12 (range 3-90) months. Of the 23 patients reviewed, seven underwent endovascular treatment or open surgery due to unresponsiveness to conservative therapy, while 16 received conservative management. All patients showed regression of symptoms. Surgical patients showed a significant improvement with a 100% patency rate during the follow-up. PS matching adjusted for baseline differences, yielding comparable groups for analysis. No significant difference between treatment approaches was observed in stroke recurrence rates, although surgical intervention showed promising outcomes in symptom resolution and stroke prevention. Both conservative and surgical management of CAD can lead to favorable outcomes. While conservative therapy remains the initial approach and proves effective, surgery appears beneficial and safe in certain cases unresponsive to conservative treatment. Further investigation through larger prospective and randomized trials is necessary to establish its safety and efficacy.

Investigating the pathophysiology and evolution of internal carotid dissection: a fluid-structure interaction simulation study.

Arterial dissection, a condition marked by the tearing of the carotid artery's inner layers, can result in varied clinical outcomes, including progression, stability, or spontaneous regression. Understanding these outcomes' underlying mechanisms is crucial for enhancing patient care, particularly with the increasing use of computer simulations in medical diagnostics and treatment planning. The aim of this study is to utilize computational analysis of blood flow and vascular wall to: (1) understand the pathophysiology of stroke-like episodes in patients with carotid artery dissection; and (2) assess the effectiveness of this method in predicting the evolution of carotid dissection. Utilizing contrast-enhanced magnetic resonance angiography (MRA), we segmented images of the patient's right internal carotid artery. These images were transformed into 3D solids for simulation in Ansys multifisic software, employing a two-way fluid structure interaction (FSI) analysis. Simulations were conducted across two wall conditions (atherosclerotic and normal) and three pressure states (hypotension, normotension, hypertension). The simulations indicated a significant pressure discrepancy between the true and false lumens of the artery. This suggests that flap motion and functional occlusion under hypertensive conditions could be the cause of the clinical episodes. Thrombotic risk and potential for dissection extension were not found to be critical concerns. However, a non-negligible risk of vessel dilation was assessed, aligning with the patient's clinical follow-up data. This study highlights specific hemodynamic parameters that could elucidate carotid artery dissection's mechanisms, offering a potential predictive tool for assessing dissection progression and informing personalized patient care strategies.

Τhe styloid process length and the stylohyoid chain ossification affect its relationship with the carotid arteries

PurposeThe elongated styloid process (SP) is associated with internal carotid artery (ICA) dissection, due to its close relationship with the vessel. However, the relationship with the variable ossified stylohyoid chain (SHC) has been scarcely studied. The current study investigated the relationship between the temporal bone's SP and the external and internal carotid arteries (ECA and ICA). The hypothesis was that the morphological variants of the SP influence this relationship. MethodsSixty multidetector computed tomography angiographies (120 heminecks) were randomly selected and retrospectively analyzed. SP elongation and the degree of SHC ossification were assessed. The distances (mm) between the SP and the carotid arteries (CAs) were measured. ResultsElongated SPs were present in 21 patients (35%), while 18 patients (30%) exhibited variable degrees of SHC ossification. The mean distance from the SP tip and ECA was 5.45±3.01mm from the ECA and 6.16±3.11mm to the ICA. The minimum distance between SP and ECA was 3.96±2.74mm, and between SP and ICA was 4.72±2.73mm. A statistically significant reduction in SP-ICA distance was observed in cases with elongated SP and SHC ossification, while the SP-ECA distance was statistically significantly shorter in cases of SP elongation. Additionally, three novel topographical patterns between the SP and surrounding vascular structures were identified. ConclusionsSP elongation and variable SHC ossification may impact the spatial relationship between the SP and the ICA/ECA. The proximity of the SP to the carotid arteries, particularly the ICA, holds clinical significance, as a reduced distance may predispose patients to carotid artery dissection, increasing the risk of stroke.

Differentiating extradural head and neck arterial fenestrations from other intraluminal abnormalities

Background and PurposeArterial fenestrations are a benign entity arising from a failure of fetal fusion. However, fenestrations in the head and neck may be misinterpreted as carotid webs or dissections. Given differences in clinical management, the differentiation of these entities is imperative. We aim to document the prevalence of these entities on CTA imaging and highlight imaging features for confident differentiation. Materials and MethodsWe retrospectively reviewed head and neck CTA studies performed at our institution over an 18-month period. The extradural common carotid, internal carotid, external carotid, and vertebral arteries were inspected for intraluminal abnormalities. These abnormalities were classified as fenestration, web, or dissection. Location and associated non-atherosclerotic calcification, pseudoaneurysm, or thrombosis were also documented. ResultsA total of 1800 head and neck CTAs were examined. Normal extradural arteries were seen in 1731 patients (1731/1800; 96.2 %). An intraluminal abnormality was evident in the remaining 69 patients (69/1800; 3.8 %). There were 16 carotid webs (16/1800; 0.9 %), 46 dissections (46/1800; 2.6 %), and 7 fenestrations (7/1800; 0.4 %). An associated non-atherosclerotic pattern of calcification was only identified in a single fenestration case (1/7; 14.3 %). Thrombosis was not identified in any fenestration case. ConclusionArterial fenestrations of the extradural head and neck arterial vasculature are evident on 0.4 % of CTAs. It is important to differentiate these benign entities from carotid webs and arterial dissections. With the appropriate knowledge and interpretive tools, characteristic imaging findings on CTA can be used for reliable differentiation.

Superb microvascular imaging is useful for diagnosis and follow‐up of common carotid artery dissection

Superb microvascular imaging is useful for diagnosis and follow‐up of common carotid artery dissection

Association of diabetes and white blood cell count with stroke in patients with carotid artery dissection

BackgroundCarotid artery dissection is an important cause of stroke. However, the predictors of ischemic stroke in patients with carotid artery dissection are controversial. The study aimed to analyze the predictors of ischemic stroke in patients with carotid artery dissection through retrospective medical records.MethodsData of discharged patients diagnosed with carotid artery dissection during 2019–2023 were retrospectively collected. Based on the occurrence of ischemic stroke, the patients were divided into the ischemic stroke or non-ischemic stroke groups. Based on the results of univariate analyses, variables with an associated P value < 0.05 were introduced into the multivariable logistic regression analysis. .ResultsA total of 165 patients were included in the study, with an average age of 55.00 (48.00, 66.00) years, including 86 patients with internal carotid artery dissection and 79 patients with vertebral artery dissection. Ischemic stroke occurred in 69 patients with carotid artery dissection. Multivariate logistic regression analysis indicated that diabetes (odds ratio [OR]: 3.144, 95% confidence interval [CI]: 1.552–6.508, P<0.002) and high white blood cells count (OR: 1.157, 95% CI: 1.02–1.327,P = 0.028) were related to the incidence of ischemic stroke in patients with carotid artery dissection.ConclusionIschemic stroke caused by carotid artery dissection causes severe damage to the nervous system. This study found that diabetes and high white blood cells count were associated with the incidence of ischemic stroke in patients with carotid artery dissection. Therefore, monitoring and controlling blood glucose levels and infections is essential in patients with carotid artery dissection to reduce the incidence of stroke.