Background: Craniocervical artery dissection is an important cause of ischemic stroke especially in young and middle aged adults. In this study, we evaluated extracrainal and intracranial artery dissections in terms of etiologies, risk factors, stroke severity and functional outcomes.
Methods: A total of 29 patients who were diagnosed with ischemic stroke due to extracranial or intracranial artery dissections were enrolled to this study. The ischemic stroke diagnosis was confirmed with diffusion weighted magnetic resonance imaging in all patients. Computed tomography angiography, magnetic resonance angiography and digital subtraction angiography were used to demonstrate the dissection. Demographic findings, risk factors and presence of trauma were evaluated. National Institute of Health Score Scale (NIHSS) was used for stroke severity
assessment at disease onset. Functional outcomes were measured with Modified Rankin Scale (mRS) at the 3rd month.
Results: Fifteen patients (51.72%) had carotid artery dissections while 12 patients (41.37%) had vertebral artery dissection (VAD), 1 (3.4%) had basilar artery dissection (BAD) and both VAD and BAD were seen in 1 patient (3.4%). Coagulopathy was detected in 12 patients (41.37%). Connective tissue disease was suspected in 3 patients (10.3%). In 6 patients, dissections occured after trauma. Nineteen patients (65.51%) presented with somatosensory deficits. The 3rd month mRS scores were in the range of 0-2 and no significant correlation was found in terms of risk factors,
etiology and trauma history.
Conclusion: Arterial dissection should be kept in mind for the clinical presentation of ischemic stroke in young adults. We think that better understanding of the risk factors, etiologies and clinical presentation of the dissections and early diagnosis-proper treatments might yield improved clinical outcomes
