Monday, May 12, 2008

Polyarterial clustered recurrence of cervical artery dissection appears to be the rule


Dittrich R, Nassenstein I, Bachmann R et al. Neurology 2007; 69: 180-186. Summary: Spontaneous cervical artery dissection is (wrongly ) thought to a monophasic disorder. The listed rate of recurrence 0-8 % over 8.6 years is low, WAYYY low. Serial MRI of 36 patients over six month showed the following: 6 % had polyarterial involvement on the first MRI. 25 % had recurrence in one or more (same or different ) arteries over the course of followup. Of the 25 %, most recurrences occurred within 4 weeks (19%), but 6 % were noted at six months. All but one of the recurrences were asymptomatic or mildly symptomatic. All patients (ie the ones with benign results) were treated with anticoagulation followed by ASA.