Elevated peripheral leukocyte counts in acute cervical artery dissection

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 .