FOLLOW-UP OF PATIENTS WITH HISTORY OF CERVICAL ARTERY DISSECTION

The rate of recurrent stroke after cervical artery dissection (CAD) remains unknown. The aim of this study was to evaluate the rate of recurrent stroke in the same territory in patients who were discharged alive after CAD. The secondary aims were to evaluate the rate of death, any stroke or transient ischemic attacks (TIA), recurrent CAD, reopening and residual headache or cervical pain. We contacted 110 consecutive patients with angiographically proven CAD who were discharged alive after CAD. Five of the 110 patients (4.5%) were lost to follow-up. The 105 remaining patients shared a total of 110 CAD (67 carotid, 43 vertebral). The median duration of follow-up was 36 months. Ninety-two patients had no event and 5 died 1-7 years after CAD. Two patients had a recurrent stroke and 3 had TIA in the territory of the previously dissected vessel; 3 had a recurrent dissection of the same vessel, revealed by TIA in 1 and isolated cervical pain in 2. Twenty-one patients had residual headache or cervical pain. In 90 patients who underwent a second angiography, reopening occurred in 52 (partial in 2) and an aneurysm in 5. The risk of recurrent stroke remains low in patients discharged alive after CAD. One of the most frequent sequelae is residual headache.