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Article Dans Une Revue Neurology Année : 2013

Cervical artery dissection: trauma and other potential mechanical trigger events.

Stefan T Engelter
  • Fonction : Auteur
Caspar Grond-Ginsbach
  • Fonction : Auteur
Tiina M Metso
  • Fonction : Auteur
Antti J Metso
  • Fonction : Auteur
Manja Kloss
  • Fonction : Auteur
Didier Leys
  • Fonction : Auteur
Marie Bodenant
  • Fonction : Auteur
Valeria Caso
  • Fonction : Auteur
Alessandro Pezzini
  • Fonction : Auteur
Leo H Bonati
  • Fonction : Auteur
Vincent Thijs
  • Fonction : Auteur
Henrik Gensicke
  • Fonction : Auteur
Juan J Martin
  • Fonction : Auteur
Anna Bersano
  • Fonction : Auteur
Emmanuel Touzé
  • Fonction : Auteur
Turgut Tatlisumak
  • Fonction : Auteur
Philippe A Lyrer
  • Fonction : Auteur
Tobias Brandt
  • Fonction : Auteur

Résumé

To examine the import of prior cervical trauma (PCT) in patients with cervical artery dissection (CeAD). In this observational study, the presence of and the type of PCT were systematically ascertained in CeAD patients using 2 different populations for comparisons: 1) age- and sex-matched patients with ischemic stroke attributable to a cause other than CeAD (non-CeAD-IS), and 2) healthy subjects participating in the Cervical Artery Dissection and Ischemic Stroke Patients Study. The presence of PCT within 1 month was assessed using a standardized questionnaire. Crude odds ratios (ORs) with 95% confidence intervals (CIs) and ORs adjusted for age, sex, and center were calculated. We analyzed 1,897 participants (n = 966 with CeAD, n = 651 with non-CeAD-IS, n = 280 healthy subjects). CeAD patients had PCT in 40.5% (38.2%-44.5%) of cases, with 88% (344 of 392) classified as mild. PCT was more common in CeAD patients than in non-CeAD-IS patients (ORcrude 5.6 [95% CI 4.20-7.37], p < 0.001; ORadjusted 7.6 [95% CI 5.60-10.20], p < 0.001) or healthy subjects (ORcrude 2.8 [95% CI 2.03-3.68], p < 0.001; ORadjusted 3.7 [95% CI 2.40-5.56], p < 0.001). CeAD patients with PCT were younger and presented more often with neck pain and less often with stroke than CeAD patients without PCT. PCT was not associated with functional 3-month outcome after adjustment for age, sex, and stroke severity. PCT seems to be an important environmental determinant of CeAD, but was not an independent outcome predictor. Because of the characteristics of most PCTs, the term mechanical trigger event rather than trauma may be more appropriate.
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Dates et versions

hal-01253345 , version 1 (09-01-2016)

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Citer

Stefan T Engelter, Caspar Grond-Ginsbach, Tiina M Metso, Antti J Metso, Manja Kloss, et al.. Cervical artery dissection: trauma and other potential mechanical trigger events.. Neurology, 2013, 80 (21), pp.1950-7. ⟨10.1212/WNL.0b013e318293e2eb⟩. ⟨hal-01253345⟩
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