E-ISSN 1309-4866
Research Article
What are the predictors of death in patients with cranio-cervical artery dissection?
1 İnönü Üniversitesi Tıp Fakültesi, Nöroloji Departmanı, Malatya, Türkiye  
Arch Neuropsychiatry ; : -
DOI: 10.5152/npa.2015.7653
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Key Words: cranio-cervical artery dissection, carotid artery dissection, vertebral artery dissection, mortality, predictor.

Objective: Few studies have reported the predictive factors related to mortality in patients with cranio-cervical artery dissections (CCAD). Our aim was to investigate the predictors related to in-hospital mortality in patients with CCAD and its subgroups.


Methods: Sixty-seven patients diagnosed with carotid artery dissection (CAD) or vertebral artery dissection (VAD), admitted to our clinic between 2000 and 2013 were reviewed retrospectively. Age, gender, modified Rankin Scale scores (pre-stroke and at admission), clinical presentation type, location of the dissection, risk factors, and treatments were analyzed as mortality-related prognostic factors. Of the 67 patients, 12 (17.9%) died, 5 (7.46%) with CAD and 7 (10.44%) with VAD. We compared the prognostic characteristics of the surviving versus deceased patients with CCAD, and in the subgroups with CAD and VAD.


Results: Age older than 45 years, severe disability at admission, presentation with stroke, and intracranial VAD occurred more frequently in deceased patients and were independent variables related to mortality in patients with CCAD and its subgroup with VAD. Severe disability at admission alone was related to mortality in patients with CAD. Hypertension and hypercholesterolemia were independent variables related to mortality in patients with CCAD.



Discussion: Severe disability at admission was a predictor of mortality in both CAD and VAD. Although the initial severity of stroke is reportedly related to poor outcomes in patients with CCAD, it has not previously been identified directly as a predictor for mortality in patients with CAD or VAD.

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