Incidence and Outcome of Cerebrovascular Events Related to Cervical Artery Dissection: The Dijon Stroke Registry

Abstract

Background Reliable epidemiological data on the true incidence of cerebrovascular events related to spontaneous cervical artery dissection, including stroke and transient ischemic attack, are scarce. Aims To evaluate the incidence, characteristics, and outcome of cerebrovascular events due to cervical artery dissection. Methods All cerebrovascular events (stroke and transient ischemic attack) occurring in Dijon, France, from 2006 to 2011, were retrieved from a population-based registry. Patients with a cervical artery dissection were identified. Incidence rates, baseline characteristics, and outcome at three-months were described. Results Among the 1368 patients with cerebrovascular events, 27 had cervical artery dissection (2·0%, 52% men, mean age 49·1 ± 17·1), including 10 patients with internal carotid artery dissection, 16 patients with vertebral artery dissection, and one patients with both internal carotid artery dissection and vertebral artery dissection. The crude incidence rate of cerebrovascular events due to cervical artery dissection was 2·97/100 000/ year. Corresponding rates were 1·21/100 000/year for internal carotid artery dissection, and 1·87/100 000/year for vertebral artery dissection. Seventy per cent of patients had a stroke and among these, higher severity was observed in those with internal carotid artery dissection. A good outcome (m-Rankin score 0–2) was observed in 89% of patients at three-months, whatever the location of the cervical artery dissection. One patient with vertebral artery dissection died at day 38. Conclusion The incidence of cerebrovascular events related to vertebral artery dissection is greater than previously reported, which may indicate a better identification of patients due to improvements in diagnostic procedures.