Systemic inflammatory markers in cerebral artery dissection (P5.158)

Objective To assess levels of blood inflammatory markers (IM) in patients with cerebral artery dissections (CAD) with and without stroke. Compare CAD patients with stroke of other etiologies and healthy controls. Evaluate the relationship between IM, imaging patterns and CAD outcomes. Background Acute inflammation developed after stroke is an important mechanism by which cells in the penumbra degenerate modifying infarct volume. IM may reflect stroke outcomes and constitute useful biomarkers. Little is known about the relationship between CAD and IM. Methods and Design Retrospective analysis of IM levels in patients with CAD with and without stroke, patients with strokes of other etiologies, and healthy controls. We measured erythrocyte sedimentation rate (ESR) or ultra sensible C reactive protein (usCRP) and white blood cells count (WBCc) within 48 hours of symptoms onset. We examined the potential association between outcome using mRs and the relationship between IM and imaging pattern of CAD. Results 136 patients with CAD, 50 cardioembolic strokes, 35 carotid territory strokes, and 50 stroke of unknown etiology. High levels of usCRP, ESR, and WBCc were found in all groups compared to controls (p=0.008). There were no significant differences in IM levels between CAD with or without strokes. We didn’t find differences between IM in CAD with prior minor trauma and spontaneous CAD. Flap and dissecting aneurysm pattern have higher levels of WBCc and ESR compared to stenosis and occlusion vessel (p=0.04) suggesting a larger inflammatory reaction in these presentations. Patients with higher levels of usCRP have worst outcome (mRs 3-6) compared to those with normal usCRP levels (p<0.05). Conclusions IM in CAD may have a predictive power to be of clinical use to predict poor outcome after stroke. CAD appears to trigger a systemic inflammatory reaction beyond the presence of brain infarction, especially in subjects with flaps and dissecting aneurysms. Disclosure: Dr. Dossi has nothing to disclose. Dr. Farez has received personal compensation for activities with Merck Serono. Dr. Carpani has nothing to disclose. Dr. Calandri has nothing to disclose. Dr. Pujol Lereis has nothing to disclose. Dr. Povedano has nothing to disclose. Dr. Ameriso has nothing to disclose.