Front Neurol. 2026 Sep 15;17:1726823. doi: 10.3389/fneur.2026.1726823. eCollection 2026.
ABSTRACT
INTRODUCTION: Most patients with Cervical Artery Dissection (CeAD) experience good long-term functional outcome. Little is known about long-term psychological sequelae in these patients.
PATIENTS AND METHODS: In CeAD-patients, we assessed long-term quality of life (QoL), frequency of increased anxiety levels, post-traumatic stress disorder (PTSD), depression and fatigue and explored if baseline characteristics can identify patients at high risk of developing the aforementioned. We performed long-term follow-up (> = 12 months after baseline) in CeAD-patients with excellent 3-month outcome and no prior psychiatric disorder. Patients were asked to answer established questionnaires.
RESULTS: Long-term follow-up was performed on 89 CeAD-patients at a median of 53 months after baseline. Sixty-five patients had carotid artery dissection and 37 patients had vertebral artery dissection (13 patients had both). At long-term follow-up the threshold for formal diagnosis of anxiety was met by 14.6, and 11.2% met the criteria for PTSD. 29.2% had a score above threshold for significant peri-traumatic dissociation. 19.1% reported depression at any point between baseline and long-term follow-up and 48.3% scored above thresholds for abnormal fatigue. Those who experienced increased levels of anxiety and those who met criteria for PTSD reported reduced QoL. Peritraumatic dissociation at the acute phase of CeAD was associated with increased anxiety levels at long-term follow-up. Occlusion of the dissected artery, tinnitus at baseline and prior smoking were associated with PTSD at long-term follow-up.
DISCUSSION: Prognostic importance of the experience of peritraumatic dissociation as well as occlusion of the dissected artery requires further research. Further prospective and interventional studies in treatment of psychological sequela in CeAD-patients are warranted.
CONCLUSION: CeAD-patients seem to have a high long-term risk of developing anxiety, depression or PTSD, which was accompanied by decreased QoL. These findings are exploratory and should be further confirmed.
PMID:42812179 | PMC:PMC13619388 | DOI:10.3389/fneur.2026.1726823