Recurrence of cervical artery dissection. A prospective study of 81 patients.
OBJECTIVE
Spontaneous cervical artery dissection (SCAD) is a common cause of stroke in the young; however, its recurrence has been rarely studied. Recurrent SCAD at the level of the previously dissected vessel has been reported in only six patients.


METHODS
We prospectively evaluated and followed a series of 81 patients seen in our center with carotid (n = 66) or vertebral (n = 15) artery dissection, in whom the diagnosis was confirmed by angiography, MRI, or both. Repeated clinical and ultrasound examinations were performed in all patients during a mean follow-up of 34 months (range, 12 to 57 months).


RESULTS
Three patients died of the consequences of stroke, and four patients were unavailable for follow-up. Three of the remaining 74 patients (4%) had a recurrent carotid dissection while under prophylaxis with aspirin (n = 2) or anticoagulation (n = 1). None of the patients had a recurrent vertebral dissection. Recurrent carotid dissection occurred 16 months to 4 years after the first episode and presented with acute head and neck pain (n = 2) and hemispheric transient ischemic attack (n = 1). In one patient recurrence was documented by Doppler and MRI at the level of the first dissection.


CONCLUSIONS
We confirm that recurrence of SCAD is uncommon and usually represents a benign condition. Delayed recurrence seems to be more common than previously suggested and can occur at the level of the previously dissected vessel.
Bassetti
C
C
Department of Neurology, University Hospital, Inselspital, Bern, Switzerland.
Carruzzo
A
A
Sturzenegger
M
M
Tuncdogan
E
E
D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality; D000792:Angiography; D002339:Carotid Arteries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D014463:Ultrasonography; D014711:Vertebral Artery