Outcome of Acute Ischemic Stroke Caused by Cervicocephalic Arterial Dissection Following Intravenous Thrombolysis and/or Endovascular Treatment. (P5.160)

OBJECTIVE: To examine the outcome of acute ischemic strokes caused by cervicocephalic arterial dissection arterial who underwent intravenous thrombolysis (IV tPA) and/or endovascular treatment. BACKGROUND: Cervicocephalic arterial dissections account for 2[percnt] of strokes in all age groups, and up to 25[percnt] in patients aged 45 years or younger. The incidence of diagnosis of this condition is increasing with advancement in imaging techniques. The safety and efficacy of intravenous thrombolysis (IV tPA) and endovascular treatment in this group of patients have not been well studied. DESIGN/METHODS: We retrospectively reviewed the medical charts and neuroimages of patients who received IV rtPA for acute ischemic stroke from January 2006 to April 2014 in our center. Patients who were diagnosed with cervicocephalic arterial dissection were identified. A subgroup of these patients had undergone endovascular therapy following intravenous thrombolysis (IV-tPA). Outcome and safety of treatment were measured with NIHSS at discharge, symptomatic intracranial hemorrhage (ICH) within 24 hours of receiving the treatment and Modified Ranking Scale (mRS) at three months. RESULTS: 637 patients received IV rtPA for acute ischemic stroke, from whom 11 (1.7[percnt]) found to have cervico-cephalic arterial dissections. Seven of those undergone endovascular treatment after receiving IV rtPA. Out of 11, there was one death observed because of brain edema and herniation on day 5 post stroke and one symptomatic intracranial hemorrhage 28 hours after receiving IV rtPA. Mean NIHSS at admission was 14.3. Mean NIHSS at discharge was 4.3. Mean 90 day mRS was 2.09 and 5 (45[percnt]) had mRS of 0 in three months suggesting favorable outcome. CONCLUSIONS: The study suggests that intravenous thrombolysis with or without endovascular treatment might improve the outcome in acute ischemic stroke caused by cervicocephalic arterial dissections. Study Supported by: Disclosure: Dr. Ahmad has nothing to disclose. Dr. Shirani has nothing to disclose. Dr. Mowla has nothing to disclose. Dr. Masud has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Sawyer has nothing to disclose. Dr. Ching has nothing to disclose. Dr. Crumlish has nothing to disclose.