Without treatment of blunt cervical artery injuries, approximately 30% of patients will suffer an ischemic stroke, with an associated mortality rate of 10% to 24%, with 27% to 32% of those suffering permanent neurological deficits.29,42,46 Strokes occur within the first 24 hours in 36% to 56% of patients and within the first 7 days in 78% to 82% of cases.22,40 CADISS looked at 982 patients who presented with stroke due to cervical artery dissections and stroke and assessed risk factors, baseline features, and outcomes. That study showed an overall favorable outcome at 3 months in approximately 75% of patients with carotid artery dissections and strokes and in 93% with vertebral artery dissections. A worse 3-month outcome was seen if they had a more-severe stroke at onset, arterial occlusion, or older age. The recurrence rate of strokes was around 1% to 2%, mostly in the first 2 weeks.27 Long-term prognosis without stroke is usually quite good.
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