Abstract TP217: Prognostic Factors in Craniocervical Artery Dissection: A Latin American Cohort Study.

Abstract

Introduction: Craniocervical arterial dissection (CCAD) accounts for only a small proportion of ischemic stroke, but it represents 20 to 25% of cases among younger adults. The prognosis of CCAD is generally favorable. In Latin American populations, epidemiological and clinical studies are scarce. This study examines prognostic factors in a multiethnic Latin American cohort with CCAD, aiming to identify key predictors of outcomes in this diverse population. Methods: We conducted a 6-month follow-up study, assessing clinical outcomes in patients diagnosed with CCAD. Data collection included demographic information, clinical presentation, imaging findings, and treatment approaches. Patients were monitored for functional recovery using the modified Rankin Scale (mRS) at baseline and at the 6-month follow-up between January 2013 and June 2023. Results: A total of 192 patients with CCAD were included,with 55.2% men, 42.9% black, median age 45 (SD: ±13.9). At hospital discharge, the median of mRS was 3 (IQR: 2.00, 45.7% with mRS 0-2). After 6 months post-stroke, the median mRS was 1 (IQR: 3.00), with 73.9% patients scoring between 0 and 2. Extracranial and anterior territory dissection patients were more likely to have higher NIHSS at admission (5 vs 2.5, p>0.05. IC95%, 2.39-3.00, 5,5 vs 2, p<0,001 IC95%-4 a -2, respectively). In multivariate analysis, diabetes and the NIHSS score at admission were independent risk factors for unfavorable outcomes at 6 months: diabetes increased the risk of unfavorable outcomes by over 6 times (OR: 8.78, 95% CI: 1.74 – 44.16, p = 0.008), and for each 1-point increase in the NIHSS score, the risk increased by 1.18 times (OR: 1.18, 95% CI: 1.06 – 1.32, p = 0.002). Thrombolysed patients had more severe strokes (median NIHSS score 13 vs. 3; P < 0.001). However, IVT and MT were neither independently associated with unfavourable outcome too. Conclusions: Overall, CCAD is associated with favorable clinical outcomes: Extracranial cervical artery dissection, anterior territory, NIHSS at admission and diabetes were factors associated with less favorable outcomes in a multiethnic Brazilian population. More studies in mixed and ethnic diverse populations are needed to confirm our findings.