Recanalization of cervical artery dissection: influencing factors and role in neurological outcome

• Published in: Cerebrovascular diseases (Basel, Switzerland) Vol. 17; no. 2-3; p. 93
• Main Authors: Caso, Valeria, Paciaroni, Maurizio, Corea, Francesco, Hamam, Mohammed, Milia, Paolo, Pelliccioli, Gian Piero, Parnetti, Lucilla, Gallai, Virgilio
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2004
• Subjects: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants - therapeutic use; Carotid Artery, Internal, Dissection - drug therapy; Carotid Artery, Internal, Dissection - epidemiology; Cerebrovascular Circulation; Collateral Circulation; Female; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors - therapeutic use; Prospective Studies; Risk Factors; Stroke - drug therapy; Stroke - epidemiology; Treatment Outcome; Vertebral Artery Dissection - drug therapy; Vertebral Artery Dissection - epidemiology
• ISSN: 1015-9770
• DOI: 10.1159/000075775

Generally, the prognosis for cervical artery dissection (CAD) is uncertain. The recanalization rate of CAD can be up to 85% within 3 months. This study evaluates the variables that might affect recanalization and the role of recanalization as a predictor for neurological outcome.
This study prospectively included 38 patients with acute stroke following occlusion due to CAD (18 males, 20 females, median age 50.5 years, range 16-82). Vertebral and carotid dissections were equally distributed (19 carotid dissections). The recanalization rate was influenced by the presence of hypertension (p = 0.001). Outcomes were dependent on infarct location. Patients with lateral medullary infarction returned to functional independence (p = 0.026), while patients with deep hemispheric infarction tended to have a disabling stroke (p = 0.068). The presence of good collaterals seemed to influence functional independence (p = 0.03).
There seemed to be no relationship between outcome and the rate of recanalization following CAD. Recanalization appeared to be a spontaneous mechanism, which could have depended on the intrinsic condition of the vessels. Finally, neurological outcome was dependent on lesion localization and the presence of good collaterals.