CLINICAL CHARACTERISTICS OF PATIENTS WITH SPONTANEOUS CERVICAL ARTERY DISSECTION IN THE ARCADIA-SCEAD-POL STUDY

Objective: Spontaneous cervical artery dissection (SCeAD) is a cause of stroke in young adults and may be linked to fibromuscular dysplasia (FMD). SCeAD symptoms are variable and often nonspecific, making diagnosis challenging. The study aimed to evaluate the clinical characteristics of SCeAD patients and assess differences in consecutively numbered evaluations: 1) between patients with ischemic stroke/TIA and those with nonspecific symptoms/asymptomatic; 2) between patients with single and multiple artery SCeAD (2 or more arteries); 3) between patients with internal carotid artery (ICA) and vertebral artery (VA) SCeAD (single artery only). Design and method: The ARCADIA-SCeAD-Pol study (substudy of ARCADIA-Pol study) focuses on SCeAD patients referred from neurology departments in Warsaw, Cracow, and Gdansk to the National Institute of Cardiology, Warsaw, Poland. Each patient underwent clinical and 24 h ambulatory blood pressure monitoring, biochemical tests, echocardiography, Doppler ultrasound of renal and carotid arteries, and whole-body angio-CT. Data from 149 patients with confirmed SCeAD were analyzed. Results: SCeAD was identified in 129 ICA and 51 VA cases, most commonly affecting the left ICA (68 cases). Single artery SCeAD occurred in 101 patients, while 48 had multiple artery involvement. Mean age was 43.0±8.4 years, and 59.8% were women. Hypertension (HT) was present in 56.4%, hypercholesterolemia in 26.8%, and FMD lesions in any vascular bed in 26.8%. Ischemic stroke occurred in 43.6% of cases. Patients with single artery SCeAD had a higher prevalence of hypercholesterolemia than those with multiple artery SCeAD (31.5% vs. 12.8%). Among patients with ischemic stroke, the proportion of women was lower (58.0% vs. 74.0%), while HT prevalence was higher (63.6% vs. 47.8%) compared to those without ischemic stroke. No other significant differences were found in all evaluations. Conclusions: SCeAD predominantly affects young adults, with the carotid arteries being the most common site. Ischemic stroke complicates nearly half of the cases, highlighting the potential severity of the condition. The high prevalence of FMD highlights the need for active screening for FMD lesions in SCeAD patients.