Objectives: To investigate the occurrence of cervicocerebral arterial dissection in young adults, we examined the etiology of first-ever brain infarction and the timing of angiography.
Methods: One hundred eighty-four subjects with first stroke aged 16 to 49 years, admitted to the Helsinki University Hospital between 1983 and 1990 were included. Seventy-eight percent of the angiographies were performed more than 1 week after the onset of stroke symptoms.
Results: We identified 19 (10%) subjects with carotid arterial dissection and none with vertebral arterial dissection. Mortality attributed to ischemic stroke caused by carotid arterial dissection was high (26%). With longer time between onset of stroke symptoms and angiography, dissection was a rarer finding (P < .01), and there were more angiographies with no findings (P < .05). Trauma (P < .001) and headache (P < .05) preceded onset of stroke more frequently in these patients than in others.
Conclusions: Prompt imaging of the cervicocerebral arteries is indicated if the patient has preceding trauma or complains of headache and/or neck pain.