[Cervical artery dissection in Iceland: epidemiology, treatment and prognosis]

Abstract

Background: Cervical artery dissection is a common cause of ischemic stroke in young adults and middle-aged individuals. Due to advances in imaging techniques and increased knowledge, dissections are now diagnosed much more frequently than before. This study aimed to investigate the incidence of cervical artery dissection in Iceland from 2005 to 2023.

Methods: A retrospective study was conducted using medical records of individuals diagnosed with cervical artery dissection in Iceland between January 1, 2005, and December 31, 2023. The factors examined included gender, year of diagnosis, age at diagnosis, symptoms, risk factors, treatment, and prognosis. Data processing was performed using Excel® and Rstudio.

Results: The study sample consisted of 107 individuals, including 37 women and 70 men. The average incidence was 1.62 per 100,000 people per year. The incidence increased over the period, being 2.7 times higher in the latter half compared to the former. The average age of diagnosis was 50 years (range 18-101 years). The most common symptom was pain (72%), followed by sensory disturbances (67%), motor disturbances (49%), and Horner's syndrome (36%). Half of the patients experienced an ischemic stroke (51%). Five individuals (4.6%) had a recurrent dissection during the follow-up period. Dissections occurred in the internal carotid artery in 56% of cases and the vertebral artery in 44% of cases. All patients received antiplatelet and/or anticoagulant therapy. After 3-6 months, 77% had no or mild disability (0-2 on the modified Rankin scale).

Discussion: The incidence of cervical artery dissection in Iceland is consistent with findings from other studies. Diagnoses have increased in recent years, and the average incidence has risen. The majority of patients achieved good recovery, indicating effective diagnosis and treatment of cervical artery dissection in Iceland.

Keywords: cervical dissection; incidence; stroke; trauma.