Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Table 5.

Reports of Recurrent Stroke or Recurrent Dissection in Patients With Dissection

Author Method Population Recurrence Risk Comments
Bassetti et al,233 1996 Single-center, prospective cohort 81 Consecutive patients with CD All surviving patients had repeat clinical and ultrasonographic examinations; 3 of 74 patients (4%) had recurrent ICAD over ≈3 y
Guillon et al,231 1999 Single-center, retrospective cohort 16 Patients with 20 ICA dissecting aneurysms No aneurysm worsening and no recurrent strokes over mean of 37 mo
Touze et al,65 2001 Single-center, prospective cohort 35 Patients with ICA or VA dissecting aneurysms No aneurysm worsening and no recurrent strokes over mean of 42 mo
Dziewas et al,98 2003 Single-center, retrospective cohort 126 Consecutive patients with CD Recurrent CD in 4 patients (3.2%) in the first month, and an additional 2 patients (1.6%) from 1 mo–1 y
Kremer et al,225 2003 2-Center, prospective, nested, case-control study 92 Patients with either persistent (cases) or transient (controls) severe ICA stenosis or occlusion caused by dissection (at a 1-y follow-up ultrasonographic examination) Risk of subsequent stroke was 1.4%/y for cases (average follow-up, 6.2 y) and 0.6%/y for controls (average follow-up, 7.2 y)
Beletsky et al,218 2003 Multicenter, prospective cohort 116 Patients with CD Recurrent events occurred in 9 of 105 patients followed up for a rate of 10.4%/y; most of these events occurred in the first 2 wk after CD
Touze et al,234 2003 Multicenter, retrospective cohort 459 Patients with CD During a mean follow-up of 31 mo, 4 patients had ischemic stroke and 4 had recurrent CD for rates of 0.3%/y
Lee et al,8 2006 Population-based, retrospective cohort 48 Patients with CD No recurrent CD occurred with a mean follow-up of 7.8 y
Arauz et al,223 2006 Single-center, retrospective cohort 130 Patients with CD 6 Patients (4.8%) had recurrent nonfatal ischemic stroke in the first 2 wk after diagnosis; overall recurrence rate was 0.15%/y; average follow-up was 19 mo
de Bray et al,219 2007 Single-center, prospective cohort 103 Patients with CD Annual recurrence rates of stroke of 0.4% and CD of 2% with an average follow-up of 4 y
Georgiadis et al,235 2009 2-Center, retrospective cohort 355 Patients with ICA dissection 1 Ischemic stroke (0.3%) occurred during 3 mo of follow-up for each patient.
Metso et al,160 2009 Single-center, retrospective cohort 301 Patients with 322 CD 6 (2%) New CDs over 4 y (all in different arteries) and 1 stroke from a new CD
Schwartz et al,2 2009 Single-center, retrospective cohort 177 Patients with CD 15 Cases (8.5%) of recurrent ischemic events over a median of 7 mo (about half of these events were in the first 2 wk; 2 patients (1.1%) had recurrent CD
Debette et al,222 2011 Multicenter, prospective cohort 982 Patients with CD 19 (2.1%) Patients had recurrent CDs and 18 (2%) had a stroke within 3 mo of diagnosis
  • CD indicates cervical artery dissection; ICA, internal carotid artery; ICAD, internal carotid artery dissection; and VA, vertebral artery.

This Article

  1. Stroke vol. 45 no. 10 3155-3174