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The inflammatory markers and prognosis of cervicocephalic artery dissection: a stroke center study from a tertiary hospital

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Abstract

Objective

Cervicocephalic artery dissection (CeAD) is the most common cause of ischemic stroke in young adults. Although the exact cause is unknown, inflammation is thought to have a role. Here, we investigated the relationship between CeAD and inflammation.

Methods

Patients diagnosed with CeAD in our stroke center were evaluated retrospectively, and their demographic and clinical features were recorded. The C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell, neutrophil and lymphocyte counts, platelet/lymphocyte ratio (PLR), and neutrophil/lymphocyte ratio (NLR) were recorded on admission. Modified Rankin scores (mRS) were noted on admission and at 6 months to evaluate the dependency status and functional outcome of each patient.

Results

Of the 95 patients in the study, 70 (73.7%) were male, and the mean age was 44.4 ± 9.8 years. Patients with high WBC count, ESR, PLR, and NLR frequently had mRS scores of 3–6 at admission; these differences were significant (p = 0.04, p = 0.02, p = 0.04, and p = 0.02, respectively). At 6 months, patients with high CRP and ESR at admission also had significantly poorer prognoses (p < 0.001, p = 0.002, respectively). PLR and NLR values were higher in patients with mRS of 3–6. But there were no significant differences between the good and poor prognosis groups regarding PLR and NLR (p = 0.22, p = 0.05, respectively).

Conclusion

Inflammation may have a role in the prognosis of CeAD, and inflammatory markers can be evaluated as auxiliary tests for determining prognosis.

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References

  1. Debette S, Leys D (2009) Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol 8(7):668–678

    Article  Google Scholar 

  2. Lee VH, Brown RD Jr, Mandrekar JN, Mokri B (2006) Incidence and outcome of cervical artery dissection: a population-based study. Neurology 67(10):1809–1812

    Article  Google Scholar 

  3. Engelter ST, Grond-Ginsbach C, Metso TM et al (2013) Cervical Artery Dissection and Ischemic Stroke Patients Study Group. Cervical artery dissection: trauma and other potential mechanical trigger events. Neurology 80(21):1950–1957

    Article  Google Scholar 

  4. Caso V, Paciaroni M, Bogousslavsky J (2005) Environmental factors and cervical artery dissection. Front Neurol Neurosci 20:44–53

    Article  CAS  Google Scholar 

  5. Naggara O, Touzé E, Marsico R et al (2009) High-resolution MR imaging of periarterial edema associated with biological inflammation in spontaneous carotid dissection. Eur Radiol 19(9):2255–2260

    Article  Google Scholar 

  6. Pfefferkorn T, Saam T, Rominger A, Habs M, Gerdes LA, Schmidt C, Cyran C, Straube A, Linn J, Nikolaou K, Bartenstein P, Reiser M, Hacker M, Dichgans M (2011) Vessel wall inflammation in spontaneous cervical bartery dissection: a prospective, observational positron emission tomography, computed tomography, and magnetic resonance imaging study. Stroke. 42(6):1563–1568

    Article  Google Scholar 

  7. Debette S (2014) Pathophysiology and risk factors of cervical artery dissection: what have we learnt from large hospital-based cohorts? Curr Opin Neurol 27(1):20–28

    Article  Google Scholar 

  8. Metso AJ, Metso TM, Debette S, Dallongeville J, Lyrer PA, Pezzini A, Lichy C, Kloss M, Brandt T, Touzé E, Southerland AM, Worrall BB, Abboud S, del Zotto E, Leys D, Engelter S, Grond-Ginsbach C, Tatlisumak T, for the CADISP group (2012) Gender and cervical artery dissection. Eur J Neurol 19(4):594–602

    Article  CAS  Google Scholar 

  9. Arnold M, Bousser MG, Fahrni G, Fischer U, Georgiadis D, Gandjour J, Benninger D, Sturzenegger M, Mattle HP, Baumgartner RW (2006) Vertebral artery dissection: presenting findings and predictors of outcome. Stroke 37:2499–2503

    Article  Google Scholar 

  10. Völker W, Besselmann M, Dittrich R et al (2005) Generalized arteriopathy in patients with cervical artery dissection. Neurology 64(9):1508–1513

    Article  Google Scholar 

  11. Forster K, Poppert H, Conrad B, Sander D (2006) Elevated inflammatory laboratory parameters in spontaneous cervical artery dissection as compared to traumatic dissection: a retrospective case-control study. J Neurol 253(6):741–745

    Article  Google Scholar 

  12. Whiteley W, Jackson C, Lewis S, Lowe G, Rumley A, Sandercock P, Wardlaw J, Dennis M, Sudlow C (2009) Inflammatory markers and poor outcome after stroke: a prospective cohort study and systematic review of interleukin-6. PLoS Med 6(9):e1000145

    Article  Google Scholar 

  13. Xue J, Huang W, Chen X, Li Q, Cai Z, Yu T, Shao B (2017) Neutrophil-to-lymphocyte ratio is a prognostic marker in acute ischemic stroke. J Stroke Cerebrovasc Dis 26(3):650–657

    Article  Google Scholar 

  14. Kim JY, Kawabori M, Yenari MA (2014) Innate inflammatory responses in stroke: mechanisms and potential therapeutic targets. Curr Med Chem 21:2076–2097

    Article  CAS  Google Scholar 

  15. Franks ZG, Campbell RA, Weyrich AS, Rondina MT (2010) Platelet-leukocyte interactions link inflammatory and thromboembolic events in ischemic stroke. Ann N Y Acad Sci 1207:11–17

    Article  CAS  Google Scholar 

  16. Xu JH, He XW, Li Q et al (2019) Higher platelet-to-lymphocyte ratio is associated with worse outcomes after intravenous thrombolysis in acute ischaemic stroke. Front Neurol 10:1192

    Article  Google Scholar 

  17. İdil Soylu A, Arıkan Cortcu S, Uzunkaya F, Atalay YO, Bekçi T, Güngör L, Belet Ü (2017) The correlation of the platelet-to-lymphocyte ratio with the severity of stenosis and stroke in patients with carotid arterial disease. Vascular 25(3):299–306

    Article  Google Scholar 

  18. Li S, Zi W, Chen J, Zhang S, Bai Y, Guo Y, Shang X, Sun B, Liang M, Liu Y, Wan Y, Wang M, Zhao M, Liu R, Zhu W, Liu X, Xu G (2018) Feasibility of thrombectomy in treating acute ischemic stroke because of cervical artery dissection. Stroke 49(12):3075–3077

    Article  Google Scholar 

  19. CADISS trial investigators, Markus HS, Hayter E et al (2015) Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Lancet Neurol 14(4):361–367

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of Health Sciences, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Zuhuratbaba Mah. Dr. Tevfik Sağlam Cad. No: 25/2, Bakirkoy, 34147, Istanbul, Turkey

    Songul Senadim, Eda Çoban, Betül Tekin, Ayhan Köksal, Aysun Soysal & Dilek Ataklı

  2. Karabuk University Education and Research Hospital, Karabuk, Turkey

    Zeynep Ezgi Balcik

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  1. Songul Senadim
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  2. Eda Çoban
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  3. Betül Tekin
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  4. Zeynep Ezgi Balcik
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  5. Ayhan Köksal
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  7. Dilek Ataklı
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Correspondence to Songul Senadim.

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This study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Senadim, S., Çoban, E., Tekin, B. et al. The inflammatory markers and prognosis of cervicocephalic artery dissection: a stroke center study from a tertiary hospital. Neurol Sci 41, 3741–3745 (2020). https://doi.org/10.1007/s10072-020-04699-6

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  • DOI: https://doi.org/10.1007/s10072-020-04699-6

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