Clinical and Prognostic Characteristics of Carotid and Vertebral Artery Dissections at the Neurology Department of the CHI D’Aix en Provence

Abstract

Intr oduction : Cervicocephalic arterial dissection is a vascular condition caused by a cleavage within the arterial wall. While frequently investigated by radiologists, it remains less familiar to frontline clinicians. Objective : The primary objective of this study was to assess the clinical course and outcomes of intra- and extracranial arterial dissections. Methods : We conducted a single-center, retrospective and prospective descriptive study including 30 cases of carotid and/or vertebral dissections hospitalized between January 2018 and August 2023 in the Neurology Department of the Centre Hospitalier du Pays d’Aix en Provence. Magnetic resonance angiography with Fat-Sat sequences was considered the essential diagnostic tool. Results : The mean patient age was 45.1 years. In one-third of cases, ischemic stroke was the initial presentation, most often involving vertebral arteries. During hospitalization, most patients received antiplatelet therapy (93.0%) and a smaller proportion anticoagulation (13.0%). Clinical recovery occurred in an average of 4.8 months in 79.0% of followed patients. Overall, short-term outcomes were favorable in all cases, with no deaths reported; however, 30.0% of patients were lost to follow-up. Conclusion : Patients admitted for arterial dissection are typically active working adults, often presenting first to the emergency department before referral to neurology. Prognosis is generally favorable under antiplatelet therapy. Stroke is an uncommon complication, except in vertebral dissections.