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


RESULTS
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).


CONCLUSIONS
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.
Caso
Valeria
V
Department of Neuroscience, University of Perugia, Perugia General Hospital, Italy. vcaso@hotmail.com
Paciaroni
Maurizio
M
Corea
Francesco
F
Hamam
Mohammed
M
Milia
Paolo
P
Pelliccioli
Gian Piero
GP
Parnetti
Lucilla
L
Gallai
Virgilio
V
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D020215:Carotid Artery, Internal, Dissection / Q000188:drug therapy* / Q000453:epidemiology*; D002560:Cerebrovascular Circulation; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome; D020217:Vertebral Artery Dissection / Q000188:drug therapy* / Q000453:epidemiology*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors