Shu, LiqiLiqiShuAkpokiere, FavourFavourAkpokiereMandel, Daniel MDaniel MMandelField, Thalia SThalia SFieldLeon Guerrero, Christopher RChristopher RLeon GuerreroHenninger, NilsNilsHenningerMuppa, JayachandraJayachandraMuppaAffan, MuhammadMuhammadAffanHaq Lodhi, Omair UOmair UHaq LodhiHeldner, Mirjam RMirjam RHeldner0000-0002-3594-2159Antonenko, KaterynaKaterynaAntonenkoSeiffge, David JDavid JSeiffgeArnold, MarcelMarcelArnoldSalehi Omran, SetarehSetarehSalehi OmranCrandall, RossRossCrandallLester, EvanEvanLesterLópez-Mena, DiegoDiegoLópez-MenaArauz, AntonioAntonioArauzNehme, AhmadAhmadNehmeBoulanger, MarionMarionBoulangerTouzé, EmmanuelEmmanuelTouzéSousa, João AndréJoão AndréSousaSargento-Freitas, JoãoJoãoSargento-FreitasBarata, VascoVascoBarataCastro-Chaves, PauloPauloCastro-ChavesBrito, Maria TMaria TBritoKhan, MuhibMuhibKhanMallick, DaniaDaniaMallickRothstein, AaronAaronRothsteinKhazaal, OssamaOssamaKhazaalKaufmann, Josefin EJosefin EKaufmannEngelter, Stefan TStefan TEngelterTraenka, ChristopherChristopherTraenkaAguiar de Sousa, DianaDianaAguiar de SousaSoares, Mafalda DMafalda DSoaresRosa, Sara BSara BRosaZhou, LilyLilyZhouGandhi, PreetPreetGandhiMancini, StevenStevenManciniMetanis, IssaIssaMetanisLeker, Ronen RRonen RLekerPan, KellyKellyPanDantu, VishnuVishnuDantuBaumgartner, KarlKarlBaumgartnerBurton, Tina MTina MBurtonVon Rennenberg, ReginaReginaVon RennenbergNolte, Christian HChristian HNolteChoi, RichardRichardChoiMacDonald, JasonJasonMacDonaldBavarsad Shahripour, RezaRezaBavarsad ShahripourGuo, XiaofanXiaofanGuoGhannam, MalikMalikGhannamAlmajali, MohammadMohammadAlmajaliSamaniego, Edgar AEdgar ASamaniegoRioux, BastienBastienRiouxZine-Eddine, FaycalFaycalZine-EddinePoppe, AlexandreAlexandrePoppeFonseca, Ana CAna CFonsecaBaptista, Maria FMaria FBaptistaCruz, DianaDianaCruzRomoli, MicheleMicheleRomoliDe Marco, GiovannaGiovannaDe MarcoLongoni, MarcoMarcoLongoniKeser, ZaferZaferKeserGriffin, Kim JKim JGriffinKuohn, LindseyLindseyKuohnFrontera, Jennifer AJennifer AFronteraAmar, Jordan YJordan YAmarGiles, James AJames AGilesZedde, MarialuisaMarialuisaZeddePascarella, RosarioRosarioPascarellaGrisendi, IlariaIlariaGrisendiNzwalo, HipolitoHipolitoNzwaloLiebeskind, David SDavid SLiebeskindMolaie, AmirAmirMolaieCavalier, AnnieAnnieCavalierKam, WaynehoWaynehoKamMac Grory, BrianBrianMac GroryAl Kasab, SamiSamiAl KasabAnadani, MohammadMohammadAnadaniKicielinski, Kimberly PKimberly PKicielinskiEltatawy, AliAliEltatawyChervak, LinaLinaChervakChulluncuy Rivas, RobertoRobertoChulluncuy RivasAziz, Yasmin NYasmin NAzizMistry, Eva AEva AMistryBakradze, EkaterinaEkaterinaBakradzeTran, Thanh LThanh LTranRodrigo-Gisbert, MarcMarcRodrigo-GisbertRequena, ManuelManuelRequenaSaleh Velez, Faddi GFaddi GSaleh VelezGarcia, Jorge OrtizJorge OrtizGarciaMuddasani, VarshaVarshaMuddasanide Havenon, AdamAdamde HavenonSanchez, SebastianSebastianSanchezVishnu, Venugopalan YVenugopalan YVishnuYaddanapudi, SridharaSridharaYaddanapudiAdams, LatashaLatashaAdamsBrowngoehl, AbigailAbigailBrowngoehlRanasinghe, TamraTamraRanasingheDunston, RandyRandyDunstonLynch, ZacharyZacharyLynchPenckofer, MaryMaryPenckoferSiegler, James EJames ESieglerMayer, SilviaSilviaMayerWilley, Joshua ZJoshua ZWilleyZubair, Adeel SAdeel SZubairCheng, Yee KuangYee KuangChengSharma, RichaRichaSharmaMarto, João PedroJoão PedroMartoKrupka, DannaDannaKrupkaKlein, PiersPiersKleinNguyen, Thanh NThanh NNguyenAsad, Syed DaniyalSyed DaniyalAsadSarwat, ZohaZohaSarwatBalabhadra, AnveshAnveshBalabhadraPatel, ShivamShivamPatelSecchi, ThaisThaisSecchiMartins, Sheila CSheila CMartinsMantovani, Gabriel PGabriel PMantovaniKim, Young DaeYoung DaeKimKrishnaiah, BalajiBalajiKrishnaiahElangovan, CheranCheranElangovanLingam, SivaniSivaniLingamQureshi, Abid YAbid YQureshiFridman, SebastianSebastianFridmanAlvarado, AlonsoAlonsoAlvaradoKhasiyev, FaridFaridKhasiyevLinares, GuillermoGuillermoLinaresMannino, MarinaMarinaManninoTerruso, ValeriaValeriaTerrusoTountopoulou, ArgyroArgyroTountopoulouTentolouris-Piperas, VasileiosVasileiosTentolouris-PiperasMartinez-Marino, Manuel MManuel MMartinez-MarinoCarrasco Wall, VictorVictorCarrasco WallIndraswari, FransiscaFransiscaIndraswariEl Jamal, Sleiman ESleiman EEl JamalLiu, ShilinShilinLiuZhou, MinMinZhouAlvi, Muhammad MMuhammad MAlviAli, FarmanFarmanAliSarvath, MohammedMohammedSarvathMorsi, Rami ZRami ZMorsiKass-Hout, TareqTareqKass-HoutShi, FeinaFeinaShiZhang, JinhuaJinhuaZhangSokhi, DilrajDilrajSokhiSaid, JamilJamilSaidMongare, NewnexNewnexMongareSimpkins, Alexis NAlexis NSimpkinsGomez, RobertoRobertoGomezSen, ShayakShayakSenGhani, MohammadMohammadGhaniElnazeir, MarwaMarwaElnazeirWangqin, RunqiRunqiWangqinXiao, HanHanXiaoKala, Narendra SNarendra SKalaKhan, FarhanFarhanKhanStretz, ChristophChristophStretzMohammadzadeh, NahidNahidMohammadzadehGoldstein, Eric DEric DGoldsteinFurie, KarenKarenFurieYaghi, ShadiShadiYaghi2024-11-132024-11-132024-10-08https://boris-portal.unibe.ch/handle/20.500.12422/103393Objectives 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, = 0.001), but not with symptomatic ICH (aOR = 1.52, 95% CI 0.79-2.92, = 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.en600 - Technology::610 - Medicine & healtharticle10.48620/761903929870910.1212/WNL.0000000000209843