Serum Neurofilament Light Chain Levels Are Associated with Clinical Characteristics and Outcome in Patients with Cervical Artery Dissection

2015 ◽  
Vol 40 (5-6) ◽  
pp. 222-227 ◽  
Author(s):  
Christopher Traenka ◽  
Giulio Disanto ◽  
David J. Seiffge ◽  
Henrik Gensicke ◽  
Lisa Hert ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Light Chain ◽  
Clinical Characteristics ◽  
Blood Sampling ◽  
Clinical Severity ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Cervical Artery

Background: Serum neurofilament light chain (sNfL) levels represent a promising marker of neuroaxonal injury. They are elevated in several neurological conditions, but their importance in cerebrovascular diseases remains unclear. In a proof of concept study, we compared sNfL levels with clinical characteristics and outcome in patients with cervical artery dissection (CeAD). Methods: A total of 49 non-traumatic CeAD patients were included. sNfL levels were measured by high-sensitivity electrochemiluminescence immunoassay. Levels were compared with regard to (i) type of presenting symptoms (local symptoms only (n = 8), transient ischemic attack (TIA; n = 10) or ischemic stroke (n = 31)), (ii) stroke severity quantified by National Institute of Health Stroke Scale (NIHSS), (iii) time interval between onset of symptoms and blood sampling and (iv) 3-month outcome as measured by the modified Rankin Scale score. Analyses were performed using univariate and multivariate linear and ordinal regression models. Results: CeAD patients presenting with stroke had significantly higher sNfL levels (median 108.9 pg/ml, interquartile range (37.8-427.7)) than patients with TIA (16.4 pg/ml (8.7-36.3), p = 0.002) or local symptoms (23.4 pg/ml (17.8-30.8), p = 0.0007). Among stroke patients, sNfL levels were positively associated with both NIHSS (p = 0.0002) and time between stroke onset and serum sampling (p = 1.9 × 10-6). Higher sNfL levels were associated with unfavorable outcome at 3 months (OR 4.67, 95% CI 1.69-12.95, p = 0.003). However, this association lost significance after adjustment for NIHSS. The highest sNfL level was observed in a TIA patient who had ischemic stroke 1 day after serum sampling for sNfL measurement. Conclusion: sNfL levels were increased in CeAD patients presenting with stroke, correlated with clinical severity and were influenced by the time point of blood sampling. The prognostic meaning of sNfL in CeAD deserves further testing.

scholarly journals Magnetic Resonance Imaging and Clinical Factors Associated With Ischemic Stroke in Patients Suspected of Cervical Artery Dissection

Stroke ◽  
2018 ◽  
Vol 49 (10) ◽  
pp. 2337-2344 ◽  
Author(s):  
J. Scott McNally ◽  
Peter J. Hinckley ◽  
Akihiko Sakata ◽  
Laura B. Eisenmenger ◽  
Seong-Eun Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Resonance Imaging ◽  
Clinical Factors ◽  
Factors Associated ◽  
Cervical Artery

CLINICAL CHARACTERISTICS OF PATIENTS WITH SPONTANEOUS CERVICAL ARTERY DISSECTION - THE POLISH REGISTRY FOR FIBROMUSCULAR DYSPLASIA (ARCADIA-POL STUDY)

2018 ◽  
Vol 36 (Supplement 1) ◽  
pp. e126
Author(s):  
P. Talarowska ◽  
E. Warchol-Celinska ◽  
I. Kurkowska-Jastrzebska ◽  
A. Kostera-Pruszczyk ◽  
D. Gasecki ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Fibromuscular Dysplasia ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cervical Artery

Migraine in cervical artery dissection and ischemic stroke patients

Neurology ◽  
2012 ◽  
Vol 78 (16) ◽  
pp. 1221-1228 ◽  
Author(s):  
T. M. Metso ◽  
T. Tatlisumak ◽  
S. Debette ◽  
J. Dallongeville ◽  
S. T. Engelter ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Stroke Patients ◽  
Cervical Artery

scholarly journals Clinical Features of Patients With Cervical Artery Dissection and Fibromuscular Dysplasia

Stroke ◽  
2021 ◽  
Author(s):  
Sonia Bonacina ◽  
Mario Grassi ◽  
Marialuisa Zedde ◽  
Andrea Zini ◽  
Anna Bersano ◽  
...  
Keyword(s):  
Risk Factor ◽  
Odds Ratio ◽  
Clinical Characteristics ◽  
Fibromuscular Dysplasia ◽  
Vascular Pathology ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Risk Factor Profile ◽  
Cervical Artery ◽  
History Of

Background and Purpose: Observational studies have suggested a link between fibromuscular dysplasia and spontaneous cervical artery dissection (sCeAD). However, whether patients with coexistence of the two conditions have distinctive clinical characteristics has not been extensively investigated. Methods: In a cohort of consecutive patients with first-ever sCeAD, enrolled in the setting of the multicenter IPSYS CeAD study (Italian Project on Stroke in Young Adults Cervical Artery Dissection) between January 2000 and June 2019, we compared demographic and clinical characteristics, risk factor profile, vascular pathology, and midterm outcome of patients with coexistent cerebrovascular fibromuscular dysplasia (cFMD; cFMD+) with those of patients without cFMD (cFMD–). Results: A total of 1283 sCeAD patients (mean age, 47.8±11.4 years; women, 545 [42.5%]) qualified for the analysis, of whom 103 (8.0%) were diagnosed with cFMD+. In multivariable analysis, history of migraine (odds ratio, 1.78 [95% CI, 1.13–2.79]), the presence of intracranial aneurysms (odds ratio, 8.71 [95% CI, 4.06–18.68]), and the occurrence of minor traumas before the event (odds ratio, 0.48 [95% CI, 0.26–0.89]) were associated with cFMD. After a median follow-up of 34.0 months (25th to 75th percentile, 60.0), 39 (3.3%) patients had recurrent sCeAD events. cFMD+ and history of migraine predicted independently the risk of recurrent sCeAD (hazard ratio, 3.40 [95% CI, 1.58–7.31] and 2.07 [95% CI, 1.06–4.03], respectively) in multivariable Cox proportional hazards analysis. Conclusions: Risk factor profile of sCeAD patients with cFMD differs from that of patients without cFMD. cFMD and migraine are independent predictors of midterm risk of sCeAD recurrence.

scholarly journals Prevalence of Cervical Artery Dissection among Hospitalized Patients with Stroke by Age in a Nationally Representative Sample from the United States

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011420
Author(s):  
Yahya B. Atalay ◽  
Pirouz Piran ◽  
Abhinaba Chatterjee ◽  
Santosh Murthy ◽  
Babak B. Navi ◽  
...  
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Representative Sample ◽  
Age Groups ◽  
Vertebral Artery Dissection ◽  
The United States ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cervical Artery ◽  
Nationally Representative

Objective:To test the hypothesis that the prevalence of cervical artery dissection remains constant across age groups, we evaluated the relationship between age and cervical artery dissection in patients with stroke using a Nationally Representative Sample from the United States.Methods:We used inpatient claims data included in the 2012-2015 releases of the National Inpatient Sample (NIS). We used validated ICD-9-CM codes to identify adults hospitalized with ischemic stroke and a concomitant diagnosis of carotid- or vertebral-artery dissection. Survey weights provided by the NIS and population estimates from the U.S. census were used to calculate nationally representative estimates. The chi-square test for trend was used to compare the prevalence of concomitant dissection among stroke hospitalizations across patient subgroups defined by age. Poisson regression and the Wald test for trend were used to evaluate whether the prevalence of hospitalizations for stroke and concomitant dissection per million person-years varied by age groups.Results:There were 17,320 (95% confidence interval [CI], 15,614-19,026) hospitalizations involving ischemic stroke and a concomitant dissection. The prevalence of dissection among stroke hospitalizations decreased across 10-year age groups from 7.2% (95% CI, 6.2%-8.1%) among persons younger than age 30 years to 0.2% (95% CI, 0.1%-0.2%) among persons older than age 80 years (P value for trend <0.001). However, the prevalence of hospitalizations for stroke and concomitant dissection increased from 5.4 (95% CI, 4.6-6.2) hospitalizations per million person-years among adults younger than age 30 to 24.4 (95% CI, 21.0-27.9) hospitalizations per million person-years among adults older than age 80 (P value for trend <0.01).Conclusions:In a nationally representative sample, the prevalence of hospitalizations for dissection-related stroke increased with age.

scholarly journals Antiplatelet vs. Anticoagulation in Cervical Artery Dissection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Sihua Liu ◽  
Xiao Zhang ◽  
Xuesong Bai ◽  
Yutong Yang ◽  
Tao Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Artery Dissection ◽  
Controlled Trials ◽  
Cervical Artery Dissection ◽  
Initial Symptom ◽  
Randomized Controlled ◽  
Cervical Artery

Objective: The optimal management for cervical artery dissection (CAD) is uncertain. This study aimed to summarize the current randomized controlled trials (RCTs) to compare the efficacy and safety of antiplatelet and anticoagulation therapies for CAD.Methods: A literature search was conducted in the major databases, such as MEDLINE, Embase, and the Cochrane Library. Only the RCTs comparing the antiplatelet and anticoagulation therapies for the patients with CAD were included. Combined estimates of the relative risk (RR) of antiplatelet vs. anticoagulation were analyzed. Heterogeneity was measured using the I2 statistical analysis. The analyses were performed in the intention-to-treat (ITT) and per-protocol (PP) population, respectively.Results: Two RCTs involving 444 patients in the ITT population and 370 patients in the PP population were included. The quality of studies was high overall. In the ITT population, compared with the patients in the anticoagulation group, the patients in the antiplatelet group showed a higher rate of ischemic stroke within 3 months (RR = 6.73 [95% CI, 1.22–37.15], I2 = 0%, P = 0.029). No difference between these two treatment groups was found for the outcomes of transient ischemic attack (RR = 0.37 [95% CI, 0.09–1.58], I2 = 0%, P = 0.181), intracranial hemorrhage (RR = 0.33 [95% CI, 0.01–7.98], I2 = 0%, P = 0.494), major extracranial bleeding (RR = 0.31 [95% CI, 0.01–7.60], I2 = 0%, P = 0.476), or the composite of these outcomes within 3 months. For the PP population, the results of the meta-analysis of outcomes between the antiplatelet and anticoagulation groups were consistent with the ITT population.Conclusions: Compared with the antiplatelet group, the anticoagulation group has a lower risk of ischemic stroke without increasing bleeding risk when treating CAD. Anticoagulation seems to be superior over the antiplatelet in treating CAD but needs to be further tested by specifying several issues, such as location, initial symptom types, and treatment protocols.

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