ABSTRACT
@#Objective Combined with the imaging，clinical features and ultrasonic follow-up of patients with cervical artery dissection，the influencing factors of prognosis were analyzed comprehensively.Methods From January 2016 to December 2019，the clinical and imaging data of patients with ischemic stroke or transient ischemic attack（TIA） caused by CAD in our hospital were collected. After 3 months，the vascular condition was followed up by ultrasound，and the prognosis was evaluated by modified Rankin Scale score（MRS）.Results There were 48 patients with CAD，including 33 males（68.75%），15 females（31.25%），average age（48.1± 9.8），31 patients with internal carotid artery dissection（ICAD）（64.58%），17 patients with vertebral artery dissection（VAD）（35.41%）. The first symptoms were numbness and weakness of one side of limbs，34 cases（70.83%），head and neck pain 5 cases（10.42%），dizziness 6 cases（12.5%），head and neck trauma history and suspicious trauma history 3 cases（6.25%）.The most common type of cervical vascular ultrasound was intramural hematoma（25 cases，52.08%），followed by vascular occlusion in 14 cases（29.17%），double lumen structure and intimal flap in 4 cases（8.33%），and VaD in 5 cases（10.42%）. 48 cases underwent CTA：21 cases（43.75%） had double lumen sign，14 cases（29.17%） had occlusion，13 cases（27.08%） had Beaded stenosis. Digital subtraction angiography（DSA） was performed in 40 cases，most of which were double lumen sign（15 cases，37.5%），vascular occlusion in 14 cases（35%），and beaded stenosis in 10 cases（25%）. Evaluation of collateral circulation：14 cases（35%） had good collateral circulation，including 10 cases of ICAD（25%），4 cases of VAD（10%）.Evaluation of collateral circulation：14 cases（35%） had good collateral circulation，including 10 cases of ICAD（25%），4 cases of VAD（10%）.After 3 months，44 cases were followed up：9 cases（20.45%） were still occluded，28 cases（63.64%） were stenosis，7 cases（15.91%） were normal. The prognosis was good in 31 cases（70.45%） and poor in 13 cases（29.55%）. The proportion of vascular occlusion，NIHSS score，basal ganglia infarction，brainstem infarction and collateral circulation in the poor prognosis group were higher than those in the good prognosis group（P<0.05）.Conclusion The prognosis of CAD was related to vascular occlusion，NIHSS score，collateral circulation，basal ganglia and brainstem infarction，but not to the final vascular recovery.