The inflammatory markers and prognosis of cervicocephalic artery dissection: a stroke center study from a tertiary hospi
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ORIGINAL ARTICLE
The inflammatory markers and prognosis of cervicocephalic artery dissection: a stroke center study from a tertiary hospital Songul Senadim 1
&
Eda Çoban 1 & Betül Tekin 1 & Zeynep Ezgi Balcik 2 & Ayhan Köksal 1 & Aysun Soysal 1 & Dilek Ataklı 1
Received: 24 May 2020 / Accepted: 28 August 2020 # Fondazione Società Italiana di Neurologia 2020
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. Keywords Cervicocephalic artery dissection . Stroke . Inflammatory markers . Modified Rankin scores . Platelet/lymphocyte ratio . Neutrophil/lymphocyte ratio
Introduction Cervicocephalic artery dissection (CeAD) is an important cause of stroke, accounting for 1~2% of ischemic strokes in all age groups and 10~25% in those under 45 years of age [1].
The average annual incidence of internal carotid artery dissection is 1.72 per 100,000 individuals, and that for vertebral artery dissection is 0.97 per 100,000, for a combined annual incidence of 2.6 per 100,000 [2]. CeAD may occur spontaneously or after trauma [3]. Although the exact cause is
* Songul Senadim [email protected]
Aysun Soysal [email protected] Dilek Ataklı [email protected]
Eda Çoban [email protected] Betül Tekin [email protected]
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
2
Karabuk University Education and Research Hospita
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