title: Elevated peripheral leukocyte counts in acute cervical artery dissection.
abstract: OBJECTIVE
  It has been suggested that inflammation may play a role in the development of cervical artery dissection (CeAD), but evidence remains scarce.
  
  
  METHODS
  A total of 172 patients were included with acute (< 24 h) CeAD and 348 patients with acute ischaemic stroke (IS) of other (non-CeAD) causes from the Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) study, and 223 age- and sex-matched healthy control subjects. White blood cell (WBC) counts collected at admission were compared across the three groups.
  
  
  RESULTS
  Compared with healthy control subjects, CeAD patients and non-CeAD stroke patients had higher WBC counts (P < 0.001). Patients with CeAD had higher WBC counts and were more likely to have WBC > 10 000/μl than non-CeAD stroke patients (38.4% vs. 23.0%, P < 0.001) and healthy controls (38.4% vs. 8.5%, P < 0.001). WBC counts were higher in CeAD (9.4 ± 3.3) than in IS of other causes (large artery atherosclerosis, 8.7 ± 2.3; cardioembolism, 8.2 ± 2.8; small vessel disease, 8.4 ± 2.4; undetermined cause, 8.8 ± 3.1; P = 0.022). After adjustment for age, sex, stroke severity and vascular risk factors in a multiple regression model, elevated WBC count remained associated with CeAD, as compared with non-CeAD stroke patients [odds ratio (OR) = 2.56; 95% CI 1.60-4.11; P < 0.001) and healthy controls (OR = 6.27; 95% CI 3.39-11.61; P < 0.001).
  
  
  CONCLUSIONS
  Acute CeAD was associated with particularly high WBC counts. Leukocytosis may reflect a pre-existing inflammatory state, supporting the link between inflammation and CeAD.
authors.affiliation: Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Grond-Ginsbach
authors.forename: A
authors.initials: A
authors.lastname: Giossi
authors.forename: S S
authors.initials: SS
authors.lastname: Aksay
authors.forename: S T
authors.initials: ST
authors.lastname: Engelter
authors.forename: P A
authors.initials: PA
authors.lastname: Lyrer
authors.forename: T M
authors.initials: TM
authors.lastname: Metso
authors.forename: A J
authors.initials: AJ
authors.lastname: Metso
authors.forename: T
authors.initials: T
authors.lastname: Tatlisumak
authors.forename: S
authors.initials: S
authors.lastname: Debette
authors.forename: D
authors.initials: D
authors.lastname: Leys
authors.forename: V
authors.initials: V
authors.lastname: Thijs
authors.forename: A
authors.initials: A
authors.lastname: Bersano
authors.forename: S
authors.initials: S
authors.lastname: Abboud
authors.forename: M
authors.initials: M
authors.lastname: Kloss
authors.forename: C
authors.initials: C
authors.lastname: Lichy
authors.forename: A
authors.initials: A
authors.lastname: Grau
authors.forename: A
authors.initials: A
authors.lastname: Pezzini
authors.forename: E
authors.initials: E
authors.lastname: Touzé
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000097:blood*; D002536:Cerebral Arteries / Q000473:pathology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020521:Stroke / Q000097:blood* / Q000209:etiology
keywords: cervical artery dissection; inflammation; leukocytosis; white blood cell count