ABSTRACT NUMBER: ESOC2026A2221 FACTORS ASSOCIATED WITH A FAVORABLE OUTCOME IN CERVICOCEPHALIC ARTERIAL DISSECTION: A SINGLE-CENTER RETROSPECTIVE COHORT STUDY

Abstract Background and aims Cervicocephalic arterial dissection (CAD),, account for nearly one quarter of stroke in adults under 50 years. Clinical presentation of CAD is heterogeneous, ranging from mild symptoms to severe stroke Greater awareness of this condition have increased the detection of CAD, including cases without cerebral ischemic or hemorrhagic events, raising questions regarding prognosis and optimal management. This study aimed to characterize uncomplicated CAD andidentify factors associated with favorable outcome. Methods We conducted a retrospective cohort study of patients admitted to Lariboisière Hospital (Paris, France) between 2014 and 2023 with a diagnosis of CAD. Clinical, imaging, and follow-up data were collected. Favorable outcome is defined by exclusive locoregional manifestation, absence of any cerebrovascular event and no acute parenchymal brain lesion on MRI. Results A total of 411 patients with cervical arterial dissection were included; 65.2% presented without initial cerebral complications, while 34.8% had ischemic or hemorrhagic events. Favorable outcome was independently associated with a history of migraine (OR 2.07, p < 0.001) and a longer delay to diagnosis (OR 2.50, p < 0.001). Arterial stenosis was a strong prognostic factor with a graded effect: significant stenosis (OR 0.6) and complete occlusion (OR 0.2) were associated with worse outcomes compared with absent or mild stenosis (p < 0.001). No cerebral events occurred during follow-up in patients initially free of brain injury. Conclusions Cervical arterial dissections without initial cerebral involvement have an overall favorable prognosis. Identifying prognostic factors may help improve risk stratification and support more individualized management strategies. Conflict of interest Laurine Bedoucha: nothing to disclose ; Tuan Tran: nothing to disclose ; Agnes Aghetti: nothing to disclose ; Giulia Frasca Polara: nothing to disclose; Lucas Di Meglio: nothing to disclose ; Diana Doukhi: nothing to disclose ; Eric Jouvent: nothing to disclose ; Mikael Mazighi: nothing to disclose ; Peggy Reiner: nothing to disclose