. 2024 Oct 8;103(7):e209843.

doi: 10.1212/WNL.0000000000209843. Epub 2024 Sep 19.

Intravenous Thrombolysis in Patients With Cervical Artery Dissection: A Secondary Analysis of the STOP-CAD Study

Liqi Shu¹, Favour Akpokiere¹, Daniel M Mandel¹, Thalia S Field¹, Christopher R Leon Guerrero¹, Nils Henninger¹, Jayachandra Muppa¹, Muhammad Affan¹, Omair U Haq Lodhi¹, Mirjam R Heldner¹, Kateryna Antonenko¹, David J Seiffge¹, Marcel Arnold¹, Setareh Salehi Omran¹, Ross Crandall¹, Evan Lester¹, Diego López-Mena¹, Antonio Arauz¹, Ahmad Nehme¹, Marion Boulanger¹, Emmanuel Touzé¹, João André Sousa¹, João Sargento-Freitas¹, Vasco Barata¹, Paulo Castro-Chaves¹, Maria T Brito¹, Muhib Khan¹, Dania Mallick¹, Aaron Rothstein¹, Ossama Khazaal¹, Josefin E Kaufmann¹, Stefan T Engelter¹, Christopher Traenka¹, Diana Aguiar de Sousa¹, Mafalda D Soares¹, Sara B Rosa¹, Lily Zhou¹, Preet Gandhi¹, Steven Mancini¹, Issa Metanis¹, Ronen R Leker¹, Kelly Pan¹, Vishnu Dantu¹, Karl Baumgartner¹, Tina M Burton¹, Regina Von Rennenberg¹, Christian H Nolte¹, Richard Choi¹, Jason MacDonald¹, Reza Bavarsad Shahripour¹, Xiaofan Guo¹, Malik Ghannam¹, Mohammad Almajali¹, Edgar A Samaniego¹, Bastien Rioux¹, Faycal Zine-Eddine¹, Alexandre Poppe¹, Ana C Fonseca¹, Maria F Baptista¹, Diana Cruz¹, Michele Romoli¹, Giovanna De Marco¹, Marco Longoni¹, Zafer Keser¹, Kim J Griffin¹, Lindsey Kuohn¹, Jennifer A Frontera¹, Jordan Y Amar¹, James A Giles¹, Marialuisa Zedde¹, Rosario Pascarella¹, Ilaria Grisendi¹, Hipolito Nzwalo¹, David S Liebeskind¹, Amir Molaie¹, Annie Cavalier¹, Wayneho Kam¹, Brian Mac Grory¹, Sami Al Kasab¹, Mohammad Anadani¹, Kimberly P Kicielinski¹, Ali Eltatawy¹, Lina Chervak¹, Roberto Chulluncuy Rivas¹, Yasmin N Aziz¹, Eva A Mistry¹, Ekaterina Bakradze¹, Thanh L Tran¹, Marc Rodrigo-Gisbert¹, Manuel Requena¹, Faddi G Saleh Velez¹, Jorge Ortiz Garcia¹, Varsha Muddasani¹, Adam de Havenon¹, Sebastian Sanchez¹, Venugopalan Y Vishnu¹, Sridhara Yaddanapudi¹, Latasha Adams¹, Abigail Browngoehl¹, Tamra Ranasinghe¹, Randy Dunston¹, Zachary Lynch¹, Mary Penckofer¹, James E Siegler¹, Silvia Mayer¹, Joshua Z Willey¹, Adeel S Zubair¹, Yee Kuang Cheng¹, Richa Sharma¹, João Pedro Marto¹, Danna Krupka¹, Piers Klein¹, Thanh N Nguyen¹, Syed Daniyal Asad¹, Zoha Sarwat¹, Anvesh Balabhadra¹, Shivam Patel¹, Thais Secchi¹, Sheila C Martins¹, Gabriel P Mantovani¹, Young Dae Kim¹, Balaji Krishnaiah¹, Cheran Elangovan¹, Sivani Lingam¹, Abid Y Qureshi¹, Sebastian Fridman¹, Alonso Alvarado¹, Farid Khasiyev¹, Guillermo Linares¹, Marina Mannino¹, Valeria Terruso¹, Argyro Tountopoulou¹, Vasileios Tentolouris-Piperas¹, Manuel M Martinez-Marino¹, Victor Carrasco Wall¹, Fransisca Indraswari¹, Sleiman E El Jamal¹, Shilin Liu¹, Min Zhou¹, Muhammad M Alvi¹, Farman Ali¹, Mohammed Sarvath¹, Rami Z Morsi¹, Tareq Kass-Hout¹, Feina Shi¹, Jinhua Zhang¹, Dilraj Sokhi¹, Jamil Said¹, Newnex Mongare¹, Alexis N Simpkins¹, Roberto Gomez¹, Shayak Sen¹, Mohammad Ghani¹, Marwa Elnazeir¹, Runqi Wangqin¹, Han Xiao¹, Narendra S Kala¹, Farhan Khan¹, Christoph Stretz¹, Nahid Mohammadzadeh¹, Eric D Goldstein¹, Karen Furie¹, Shadi Yaghi¹

Affiliations

Affiliation

¹ From the Department of Neurology (L.S., F. Akpokiere, D.M.M., K.P., V.D., K.B., T.M.B., N.S.K., F. Khan, C.S., N. Mohammadzadeh, E.D.G., K.F., S. Yaghi), Warren Alpert Medical School of Brown University, Providence, RI; Vancouver Stroke Program (T.S.F., L.Z., P.G.), Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Neurology (C.R.L.G.), Atrium Health, Charlotte, NC; Department of Neurology (J. Muppa, N.H.), University of Massachusetts Chan Medical School, Worcester; Department of Neurology (M. Affan, O.U.H.L.), University of Minnesota, Minneapolis; Department of Neurology (M.R.H., K.A., D.J.S., M. Arnold), Inselspital, University Hospital and University of Bern, Switzerland; Department of Neurology (S.S.O., R. Crandall), University of Colorado, Denver; Department of Neurology (E.L.), Weill Cornell Medicine, New York; ; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez (D.L.-M., A. Arauz), Mexico City, Mexico; Service de neurologie (A.N., M.B., E.T.), Université Caen Normandie, CHU Caen Normandie, France; Department of Neurology (J.A.S., J.S.-F., V.B.), Coimbra University, ; Department of Internal Medicine (P.C.-C., M.T.B.), São João University Hospital, Porto, Portugal; Department of Neurology (M.K., D.M.), Corewell Health, Grand Rapids, MI; Department of Neurology (M.K.), Mayo Clinic, Rochester, MN; Department of Neurology (A.R., O.K.), University of Pennsylvania, Philadelphia; Neurology and Neurorehabilitation (J.E.K., S.T.E., C.T.), University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research, University of Basel, and University Hospital Basel, Switzerland; Stroke Center (D.A.d.S.), Centro Hospitalar Universitário Lisboa Central, and Institute of Anatomy, Faculdade de Medicina da Universidade de Lisboa; Department of Neurology (M.D.S.); Department of Neuroradiology (S.B.R.), Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Vancouver Stroke Program (S. Mancini), Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Neurology (I.M., R.R.L.), Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Neurology with Experimental Neurology (R.V.R., C.H.N.), Charite Universitätsmedizin-Berlin and Center for Stroke Research, Berlin, and Berlin Institute of Health, Germany; Department of Neurosciences (R. Choi, J. MacDonald), ChristianaCare, Newark, DE; Department of Neurology (R.B.S.), University of California at San Diego; Department of Neurology (X.G.), Loma Linda University, Loma Linda, CA; Department of Neurology (M. Ghannam, M. Almajali, E.A.S.), University of Iowa, Iowa City; Department of Neurosciences (B.R., F.Z.-E., A.P.), Université de Montréal, Canada; Department of Neurology (A.C.F., M.F.B., D.C.), Hospital de Santa Maria, Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Portugal; Neurology and Stroke Unit (M. Romoli, G.D.M., M.L.), Department of Neuroscience, Bufalini Hospital, Cesena, Italy; Department of Neurology (Z.K., K.J.G.), Mayo Clinic, Rochester, MN; Department of Neurology (L.K., J.A.F.), NYU Langone Health, New York; Department of Neurology (J.Y.A., J.A.G.), Washington University, Saint Louis, MO; Neurology Unit, Stroke Unit (M. Zedde, I.G.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Internal Medicine (H.N.), Centro Hospital Universitario do Algarve, Faro, Portugal; Department of Neurology (D.S.L., A.M.), University of California at Los Angeles; Department of Neurology (A.C., B.M.G., R.W.), Duke University, Durham, NC; Department of Neurology (W.K.), University of North Carolina Health Rex, Raleigh; Department of Neurology (S.A.K., M. Anadani), Medical University of South Carolina, Charleston, SC; Department of Neurosurgery (K.P.K.), Medical University of South Carolina, Charleston, SC; Department of Neurology (A.E., L.C., R.C.R., Y.N.A., E.A.M.), University of Cincinnati Medical Center, OH; Department of Neurology (E.B., T.L.T.), University of Alabama at Birmingham; Department of Neurology (M.R.-G., M. Requena), University Hospital Vall d'Hebron, Barcelona, Spain; Department of Neurology (F.G.S.V., J.O.G.), University of Oklahoma; Department of Neurology (V.M.), Einstein-Jefferson Healthcare Network, Philadelphia, PA; Department of Neurology (A.H.), University of Utah, Salt Lake City; Department of Neurology (A.H.); Department of Neurology (S. Sanchez, A.S.Z., Y.K.C., R.S.), Yale New Haven Hospital, New Haven, CT; Department of Neurology (V.Y.V.), All India Institute of Medical Sciences, New Delhi, India; Department of Neurology (S. Yaddanapudi, L.A., A. Browngoehl), Thomas Jefferson University, Philadelphia, PA; Department of Neurology (T.R., R.D., Z.L.), Wake Forest Medical Center, NC; Department of Neurology (M.P., J.E.S.), Cooper University, Camden, NJ; Department of Neurology (S. Mayer, J.Z.W.), Columbia University Medical Center, New York, NY; Department of Neurology (J.P.M., D.K.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; Department of Neurology (P.K., T.N.N.), Boston Medical Center, MA; Department of Neurology (S.D.A., Z.S., A. Balabhadra, S.P.), Hartford Hospital, CT; Department of Neurology (T.S.), Hospital Moinhos de Vento; Department of Neurology (S.C.M., G.P.M.), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Neurology (Y.D.K.), Yonsei University, Seoul, South Korea; Department of Neurology (B.K., C.E.), University of Tennessee at Memphis; Department of Neurology (S. Lingam, A.Y.Q.), Kansas University Medical Center, Kansas City; Department of Neurology (S.F., A. Alvarado), Western Ontario University, London, Canada; Department of Neurology (F. Khasiyev, G.L.), Saint Louis University, MO; Department of Neurology and Stroke Unit (M.M., V.T.), AOOR Villa Sofia-V. Cervello, Palermo, Italy; First Department of Neurology (A.T., V.T.-P.), National and Kapodistrian University of Athens, Greece; Department of Neurology (M.M.M.-M., V.C.W.), Centro Médico Nacional Siglo XXI IMSS., México City; Department of Neurology (F.I., S.E.E.J.), The Miriam Hospital, Providence, RI; Department of Neurocritical Care (S. Liu, M. Zhou), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology, Hefei, China; Department of Neurology (M.M.A., F. Ali, M.S.), West Virginia University, WV; Department of Neurology (R.Z.M., T.K.-H.), University of Chicago, IL; Department of Neurology (F.S., J.Z.), Sir Run Run Shaw Hospital of Zhejiang University Medical School, Hangzhou, China; Department of Neurology (D.S., J.S., N. Mongare), Aga Khan University, Nairobi, Kenya; Department of Neurology (A.N.S., R.G., Shayak Sen), Cedars Sinai Medical Center, Los Angeles, CA; Department of Neurology (M. Ghani, M.E.), University of Louisville, KY; and Department of Economics (H.X.), University of California, Santa Barbara.

PMID: 39298709
PMCID: PMC11415265
DOI: 10.1212/WNL.0000000000209843

Intravenous Thrombolysis in Patients With Cervical Artery Dissection: A Secondary Analysis of the STOP-CAD Study

Liqi Shu et al. Neurology. 2024.

. 2024 Oct 8;103(7):e209843.

doi: 10.1212/WNL.0000000000209843. Epub 2024 Sep 19.

Authors

Affiliation

¹ From the Department of Neurology (L.S., F. Akpokiere, D.M.M., K.P., V.D., K.B., T.M.B., N.S.K., F. Khan, C.S., N. Mohammadzadeh, E.D.G., K.F., S. Yaghi), Warren Alpert Medical School of Brown University, Providence, RI; Vancouver Stroke Program (T.S.F., L.Z., P.G.), Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Neurology (C.R.L.G.), Atrium Health, Charlotte, NC; Department of Neurology (J. Muppa, N.H.), University of Massachusetts Chan Medical School, Worcester; Department of Neurology (M. Affan, O.U.H.L.), University of Minnesota, Minneapolis; Department of Neurology (M.R.H., K.A., D.J.S., M. Arnold), Inselspital, University Hospital and University of Bern, Switzerland; Department of Neurology (S.S.O., R. Crandall), University of Colorado, Denver; Department of Neurology (E.L.), Weill Cornell Medicine, New York; ; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez (D.L.-M., A. Arauz), Mexico City, Mexico; Service de neurologie (A.N., M.B., E.T.), Université Caen Normandie, CHU Caen Normandie, France; Department of Neurology (J.A.S., J.S.-F., V.B.), Coimbra University, ; Department of Internal Medicine (P.C.-C., M.T.B.), São João University Hospital, Porto, Portugal; Department of Neurology (M.K., D.M.), Corewell Health, Grand Rapids, MI; Department of Neurology (M.K.), Mayo Clinic, Rochester, MN; Department of Neurology (A.R., O.K.), University of Pennsylvania, Philadelphia; Neurology and Neurorehabilitation (J.E.K., S.T.E., C.T.), University Department of Geriatric Medicine FELIX PLATTER, Department of Clinical Research, University of Basel, and University Hospital Basel, Switzerland; Stroke Center (D.A.d.S.), Centro Hospitalar Universitário Lisboa Central, and Institute of Anatomy, Faculdade de Medicina da Universidade de Lisboa; Department of Neurology (M.D.S.); Department of Neuroradiology (S.B.R.), Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Vancouver Stroke Program (S. Mancini), Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Neurology (I.M., R.R.L.), Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Neurology with Experimental Neurology (R.V.R., C.H.N.), Charite Universitätsmedizin-Berlin and Center for Stroke Research, Berlin, and Berlin Institute of Health, Germany; Department of Neurosciences (R. Choi, J. MacDonald), ChristianaCare, Newark, DE; Department of Neurology (R.B.S.), University of California at San Diego; Department of Neurology (X.G.), Loma Linda University, Loma Linda, CA; Department of Neurology (M. Ghannam, M. Almajali, E.A.S.), University of Iowa, Iowa City; Department of Neurosciences (B.R., F.Z.-E., A.P.), Université de Montréal, Canada; Department of Neurology (A.C.F., M.F.B., D.C.), Hospital de Santa Maria, Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Portugal; Neurology and Stroke Unit (M. Romoli, G.D.M., M.L.), Department of Neuroscience, Bufalini Hospital, Cesena, Italy; Department of Neurology (Z.K., K.J.G.), Mayo Clinic, Rochester, MN; Department of Neurology (L.K., J.A.F.), NYU Langone Health, New York; Department of Neurology (J.Y.A., J.A.G.), Washington University, Saint Louis, MO; Neurology Unit, Stroke Unit (M. Zedde, I.G.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Internal Medicine (H.N.), Centro Hospital Universitario do Algarve, Faro, Portugal; Department of Neurology (D.S.L., A.M.), University of California at Los Angeles; Department of Neurology (A.C., B.M.G., R.W.), Duke University, Durham, NC; Department of Neurology (W.K.), University of North Carolina Health Rex, Raleigh; Department of Neurology (S.A.K., M. Anadani), Medical University of South Carolina, Charleston, SC; Department of Neurosurgery (K.P.K.), Medical University of South Carolina, Charleston, SC; Department of Neurology (A.E., L.C., R.C.R., Y.N.A., E.A.M.), University of Cincinnati Medical Center, OH; Department of Neurology (E.B., T.L.T.), University of Alabama at Birmingham; Department of Neurology (M.R.-G., M. Requena), University Hospital Vall d'Hebron, Barcelona, Spain; Department of Neurology (F.G.S.V., J.O.G.), University of Oklahoma; Department of Neurology (V.M.), Einstein-Jefferson Healthcare Network, Philadelphia, PA; Department of Neurology (A.H.), University of Utah, Salt Lake City; Department of Neurology (A.H.); Department of Neurology (S. Sanchez, A.S.Z., Y.K.C., R.S.), Yale New Haven Hospital, New Haven, CT; Department of Neurology (V.Y.V.), All India Institute of Medical Sciences, New Delhi, India; Department of Neurology (S. Yaddanapudi, L.A., A. Browngoehl), Thomas Jefferson University, Philadelphia, PA; Department of Neurology (T.R., R.D., Z.L.), Wake Forest Medical Center, NC; Department of Neurology (M.P., J.E.S.), Cooper University, Camden, NJ; Department of Neurology (S. Mayer, J.Z.W.), Columbia University Medical Center, New York, NY; Department of Neurology (J.P.M., D.K.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; Department of Neurology (P.K., T.N.N.), Boston Medical Center, MA; Department of Neurology (S.D.A., Z.S., A. Balabhadra, S.P.), Hartford Hospital, CT; Department of Neurology (T.S.), Hospital Moinhos de Vento; Department of Neurology (S.C.M., G.P.M.), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Neurology (Y.D.K.), Yonsei University, Seoul, South Korea; Department of Neurology (B.K., C.E.), University of Tennessee at Memphis; Department of Neurology (S. Lingam, A.Y.Q.), Kansas University Medical Center, Kansas City; Department of Neurology (S.F., A. Alvarado), Western Ontario University, London, Canada; Department of Neurology (F. Khasiyev, G.L.), Saint Louis University, MO; Department of Neurology and Stroke Unit (M.M., V.T.), AOOR Villa Sofia-V. Cervello, Palermo, Italy; First Department of Neurology (A.T., V.T.-P.), National and Kapodistrian University of Athens, Greece; Department of Neurology (M.M.M.-M., V.C.W.), Centro Médico Nacional Siglo XXI IMSS., México City; Department of Neurology (F.I., S.E.E.J.), The Miriam Hospital, Providence, RI; Department of Neurocritical Care (S. Liu, M. Zhou), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology, Hefei, China; Department of Neurology (M.M.A., F. Ali, M.S.), West Virginia University, WV; Department of Neurology (R.Z.M., T.K.-H.), University of Chicago, IL; Department of Neurology (F.S., J.Z.), Sir Run Run Shaw Hospital of Zhejiang University Medical School, Hangzhou, China; Department of Neurology (D.S., J.S., N. Mongare), Aga Khan University, Nairobi, Kenya; Department of Neurology (A.N.S., R.G., Shayak Sen), Cedars Sinai Medical Center, Los Angeles, CA; Department of Neurology (M. Ghani, M.E.), University of Louisville, KY; and Department of Economics (H.X.), University of California, Santa Barbara.

PMID: 39298709
PMCID: PMC11415265
DOI: 10.1212/WNL.0000000000209843

Abstract

Objectives: Cervical artery dissection (CeAD) accounts for 25% of ischemic strokes in young adults. This study evaluated the benefits and harms of intravenous thrombolysis (IVT) in patients presenting with spontaneous CeAD and acute ischemic stroke symptoms.

Methods: This analysis used data from the retrospective STOP-CAD study and included patients with spontaneous CeAD who presented within 1 day of acute ischemic stroke symptoms. Patients were dichotomized into those who received IVT and those managed without IVT. We assessed the association between IVT and 90-day functional independence (modified Rankin Scale scores 0-2) and the incidence of symptomatic intracranial hemorrhage (ICH, defined as ICH causing new or worsening neurologic symptoms within 72 hours after CeAD diagnosis).

Results: This study included 1,653 patients from the original STOP-CAD cohort of 4,023. The median age was 49 years, and 35.1% were women; 512 (31.0%) received IVT. IVT was associated with 90-day functional independence (adjusted odds ratio [aOR] = 1.67, 95% CI 1.23-2.28, p = 0.001), but not with symptomatic ICH (aOR = 1.52, 95% CI 0.79-2.92, p = 0.215).

Discussion: In patients with spontaneous CeAD and suspected ischemic stroke, IVT improved functional outcomes, without increasing symptomatic ICH risk. These findings support current guideline recommendations to consider thrombolysis for otherwise eligible patients with CeAD.

Classification of evidence: This study provides Class III evidence that IVT significantly increases the probability of 90-day functional independence in patients with CeAD.

PubMed Disclaimer

Conflict of interest statement

Disclosures provided by T. Nguyen in compliance with American Heart Association annual Journal Editor Disclosure Questionnaire are available at https://www.ahajournals.org/editor-coi-disclosures; M. Arnold reports compensation from Boehringer Ingelheim, AstraZeneca, Bayer, Bristol-Myers Squibb, Covidien, Daiichi Sankyo, Novartis, Sanofi, Pfizer, Medtronic, Novo Nordisk, and Amgen for consultant services. E. Lester reports a provisional patent for Methods and compositions for disrupting tau aggregates. E. Touze reports compensation from Elsevier for other services and employment by Caen. J.E. Kaufmann reports grants from Goldschmidt Jacobson-Stiftung. C. Traenka reports travel support from Bayer Healthcare. D. Aguiar de Sousa reports compensation from Daiichi Sankyo, Bayer, AstraZeneca, Johnson & Johnson, and Fundação Bial for other services, compensation from the University of British Columbia for data and safety monitoring services, and compensation from Organon & Co for consultant services. S. Rosa reports grants from Merck Sharp & Dohme Corporation. T. Field reports compensation from HLS Therapeutics, AstraZeneca Canada, and Roche for consultant services, service as a board member for Destine Health, compensation from the Canadian Medical Protective Association for expert witness services, and grants from Bayer. R. Leker reports compensation from Medtronic, Ischemaview, Bayer, Abbott Diabetes Care, Biogen, Janssen Biotech, and Boehringer Ingelheim for other services. C. Nolte reports compensation from Daiichi Sankyo Europe GmbH, Boehringer Ingelheim, Pfizer, Bristol-Myers Squibb, and Alexion Pharmaceuticals for consultant services and compensation from AstraZeneca, Abbott Canada, Deutsches Zentrum für Neurodegenerative Erkrankungen, Novartis, Portola Pharmaceuticals, Deutsches Zentrum für Herz-Kreislaufforschung, and Novartis for other services. A. Poppe reports grants from Foundation Brain Canada, Heart and Stroke Foundation of Canada, and Stryker and compensation from Roche for other services. D. Liebeskind reports compensation from Medtronic, Genentech, Cerenovus, Stryker, and Rapid Medical Ltd, for consultant services. B. Mac Grory reports grants from the National Institutes of Health, employment by Duke University Medical Center, compensation from Bayer for other services, and grants from the American Heart Association, Duke Bass Connections, and the Duke Office of Physician Scientist Development. S. Al Kasab reports compensation from Stryker for other services and employment by Medical University of South Carolina. K. Kicielinski reports compensation from Stryker, Penumbra Inc., Medtronic, and MicroVention Inc., for other services, travel support from MicroVention Inc., and employment by Medical University of South Carolina and Elsevier. A. de Havenon reports stock options in TitinKM and Certus, grants from the National Institutes of Health, and compensation from Novo Nordisk for consultant services. J. Siegler reports grants from Philips and employment by the University of Chicago. J.Z. Willey reports compensation from Edwards Lifesciences Corporation and Abbott Fund for end point review committee services, compensation from UpToDate for other services, and compensation from the Abbott Laboratories for consultant services. R. Sharma reports a provisional patent for a stroke etiology classifier algorithm and grants from the National Institutes of Health Clinical Center. S. Martins reports compensation from Pfizer, Medtronic, Servier Affaires Medicales, Daiichi Sankyo, Bayer, Novo Nordisk, Novartis, Penumbra Inc., and Boehringer Ingelheim for other services. A.N. Simpkins reports grants from the National Institutes of Health. C. Stretz reports grants from Massachusetts General Hospital. K. Furie reports compensation from Janssen Biotech for consultant services. The other authors report no relevant disclosures. Go to Neurology.org/N for full disclosures.

Figures

**Figure 1. Interaction Analysis of 90-Day Functional Outcomes in Patients With Spontaneous Cervical Artery Dissection and Acute Ischemic Stroke Symptoms Treated With vs Without Intravenous Thrombolysis**
The forest plot examines the adjusted odds ratio for achieving functional independence at 90 days (mRS 0–2). The model adjusted for age and baseline NIHSS score. mRS = modified Rankin Scale.

See this image and copyright information in PMC

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Intravenous Thrombolysis in Patients With Cervical Artery Dissection: A Secondary Analysis of the STOP-CAD Study

Affiliation

Intravenous Thrombolysis in Patients With Cervical Artery Dissection: A Secondary Analysis of the STOP-CAD Study

Authors

Affiliation

Abstract

Conflict of interest statement

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