{
  "abstract": "Background Cervical artery dissection (CAD) commonly presents with local symptoms such as headache, neck pain, vertigo, and dizziness. While previous studies have largely focused on ischemic complications and radiographic outcomes, the longitudinal course of local symptoms remains poorly defined. This meta-analysis aims to better define the incidence and likelihood of local symptom improvement in CAD.Methods A systematic search of MEDLINE, Embase, and the Cochrane Library was performed for English-language studies evaluating incidence and outcomes of local symptoms in adult patients with CAD. A random-effects meta-analysis was used.Results Thirty-two of 176 studies met the inclusion criteria for meta-analysis. At least one local symptom was present in 61% of patients (95% CI, 49%–73%, n=19 studies; 2,235 patients). Among symptomatic patients with available follow-up, 82% demonstrated improvement or resolution over time (95% CI, 69%–95%, n=8 studies; 363 patients). Headache was the most frequently reported local symptom, occurring in 56% of patients (95% CI, 50%–62%, n=20 studies; 4,139 patients), followed by vertigo/dizziness (41%, 95% CI, 8%–74%, n=9 studies; 572 patients) and neck pain (39%, 95% CI, 29%–48%, n=18 studies; 3,999 patients). Among studies with longitudinal outcomes, neck pain had the most favorable prognosis, with improvement observed in nearly all patients during follow-up (100%, 95% CI, 99%–101%, n=5 studies; 175 patients). Headache improved in 75% of patients (95% CI, 50%–99%, n=8 studies; 350 patients). Only two studies reported on outcomes for vertigo/dizziness, with a pooled improvement rate of 88% (95% CI, 63%–112%; n=7 patients). Significant heterogeneity was observed across most analyses, likely reflecting variability in dissection location, treatment strategies, presence of ischemic sequelae, and duration of follow-up.Conclusions Local symptoms are common in CAD and generally have a favorable prognosis. Heterogeneity across studies highlights the need for more standardized longitudinal data to better inform prognostic counseling.Disclosures V. Chinnasamy: None. D. Renedo: None. T. Duda: None. J. Haynes: None. S. Elnazer: None. R. Hebert: None. J. Schindler: None. A. de Havenon: None. C. Matouk: None. N. Sujijantarat: None.",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "V Chinnasamy"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "D Renedo"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "T Duda"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "J Haynes"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "S Elnazer"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "R Hebert"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "J Schindler"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "A de Havenon"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT",
        "Radiology, Yale School of Medicine, New Haven, CT"
      ],
      "name": "C Matouk"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "N Sujijantarat"
    }
  ],
  "title": "E-314 Incidence and improvement of headache, neck pain, and vertigo in cervical artery dissection: a systematic review and meta-analysis",
  "uid": "3d3babc9-70ea-5edc-871b-195d1f4cf7df"
}