title: Predictors of delayed stroke in patients with cervical artery dissection.
abstract: BACKGROUND
  Stroke in patients with acute cervical artery dissection may be anticipated by initial transient ischemic or nonischemic symptoms.
  
  
  OBJECTIVE
  Identifying risk factors for delayed stroke upon cervical artery dissection.
  
  
  METHODS
  Cervical artery dissection patients from the multicenter Cervical Artery Dissection and Ischemic Stroke Patients study were classified as patients without stroke (n = 339), with stroke preceded by nonstroke symptoms (delayed stroke, n = 244), and with stroke at onset (n = 382). Demographics, clinical, and vascular findings were compared between the three groups.
  
  
  RESULTS
  Patients with delayed stroke were more likely to present with occlusive cervical artery dissection (P < 0.001), multiple cervical artery dissection (P = 0.031), and vertebral artery dissection (P < 0.001) than patients without stroke. No differences were observed in age, smoking, arterial hypertension, hypercholesterolemia, migraine, body mass index, infections during the last week, and trauma during the last month, but patients with delayed stroke had less often transient ischemic attack (P < 0.001) and local signs (Horner syndrome and cranial nerve palsy; P < 0.001).
  
  
  CONCLUSIONS
  Occlusive cervical artery dissection, multiple cervical artery dissection, and vertebral artery dissection were associated with an increased risk for delayed stroke. No other risk factors for delayed stroke were identified. Immediate cervical imaging of cervical artery dissection patients without ischemic stroke is needed to identify patients at increased risk for delayed ischemia.
authors.affiliation: Department of Neurology, Hospital of Memmingen, Memmingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Lichy
authors.forename: Antti
authors.initials: A
authors.lastname: Metso
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pezzini
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
authors.forename: Tiina
authors.initials: T
authors.lastname: Metso
authors.forename: Philippe
authors.initials: P
authors.lastname: Lyrer
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Debette
authors.forename: Vincent
authors.initials: V
authors.lastname: Thijs
authors.forename: Shérine
authors.initials: S
authors.lastname: Abboud
authors.forename: Manja
authors.initials: M
authors.lastname: Kloss
authors.forename: Yves
authors.initials: Y
authors.lastname: Samson
authors.forename: Valeria
authors.initials: V
authors.lastname: Caso
authors.forename: Maria
authors.initials: M
authors.lastname: Sessa
authors.forename: Simone
authors.initials: S
authors.lastname: Beretta
authors.forename: Chantal
authors.initials: C
authors.lastname: Lamy
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Medeiros
authors.forename: Anna
authors.initials: A
authors.lastname: Bersano
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Touze
authors.forename: Turgut
authors.initials: T
authors.lastname: Tatlisumak
authors.forename: Armin
authors.initials: A
authors.lastname: Grau
authors.forename: Tobias
authors.initials: T
authors.lastname: Brandt
authors.forename: Stefan
authors.initials: S
authors.lastname: Engelter
authors.forename: Caspar
authors.initials: C
authors.lastname: Grond-Ginsbach
mesh_terms: D000328:Adult; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology*; D020217:Vertebral Artery Dissection / Q000150:complications*