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Elevated peripheral leukocyte counts in acute cervical artery dissection

2013; Wiley; Volume: 20; Issue: 10 Linguagem: Inglês

10.1111/ene.12201

1468-1331

Caspar Grond‐Ginsbach, Alessia Giossi, Suna Su Aksay, Stefan T. Engelter, Philippe Lyrer, Tiina M. Metso, Antti J. Metso, Turgut Tatlisumak, Stéphanie Debette, Didier Leys, Vincent Thijs, Anna Bersano, Shérine Abboud, M. Kloss, Christoph Lichy, Ana Andrés, Alessandro Pezzini, Emmanuel Touzé,

Cerebrovascular and Carotid Artery Diseases

Background and purpose It has been suggested that inflammation may play a role in the development of cervical artery dissection ( C e AD ), but evidence remains scarce. Methods A total of 172 patients were included with acute (< 24 h) C e AD and 348 patients with acute ischaemic stroke (IS) of other (non‐ C e AD ) causes from the C ervical A rtery D issection and I schemic S troke P atients ( CADISP ) study, and 223 age‐ and sex‐matched healthy control subjects. White blood cell ( WBC ) counts collected at admission were compared across the three groups. Results Compared with healthy control subjects, C e AD patients and non‐ C e AD stroke patients had higher WBC counts ( P < 0.001). Patients with C e AD had higher WBC counts and were more likely to have WBC > 10 000/μl than non‐ C e AD stroke patients (38.4% vs. 23.0%, P < 0.001) and healthy controls (38.4% vs. 8.5%, P < 0.001). WBC counts were higher in C e AD (9.4 ± 3.3) than in IS of other causes (large artery atherosclerosis, 8.7 ± 2.3; cardioembolism, 8.2 ± 2.8; small vessel disease, 8.4 ± 2.4; undetermined cause, 8.8 ± 3.1; P = 0.022). After adjustment for age, sex, stroke severity and vascular risk factors in a multiple regression model, elevated WBC count remained associated with C e AD , as compared with non‐ C e AD stroke patients [odds ratio (OR) = 2.56; 95% CI 1.60–4.11; P < 0.001) and healthy controls ( OR = 6.27; 95% CI 3.39–11.61; P < 0.001). Conclusions Acute C e AD was associated with particularly high WBC counts. Leukocytosis may reflect a pre‐existing inflammatory state, supporting the link between inflammation and C e AD .