That pattern is not mysterious
discuss dosing and schedule with a qualified provider

DISSECTION P2398 - ESOC25-1847 CEREBROCERVICAL ARTERY DISSECTION AS THE UNDERLYING CAUSE OF ACUTE ISCHEMIC STROKE: A PROSPECTIVE TEN YEAR STUDY Maria Chondrogianni 1 , Aikaterini Foska 1 , Athanasios Tsibonakis 1 , Aikaterini Theodorou 1 , Georgia Papagiannopoulou 1 , Konstantinos Melanis 1 , Klearchos Psychogios 2 , Odysseas Kargiotis 2 , Apostolos Safouris 2 , Eleni Bakola 1 , Maria Ioanna Stefanou 1 , Stefanos Lachanis 3 , Georgios Velonakis 4 , Lina Palaiodimou 1 , Georgios Tsivgoulis 1,5 1 Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, 2 Stroke Unit, Metropolitan Hospital, Piraeus, Piraeus, Greece, 3 Iatropolis Magnetic Resonance Diagnostic Centre, 15231, Athens, Greece, 4 Second Department of Radiology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, 5 Department of Neurology, University of Tennessee Health Science Center, Memphis, United States Background and Aims: Cervicocerebral artery dissection (CAD) accounts for nearly 2% of acute ischemic strokes (AIS), but this rate increases up to 25% in young ( 6 months)

While additional studies are needed to determine whether elevated vitamin B 12 status may be related to cancer development, including evaluating whether it might be a potential marker of cancer, it is important for observational studies to adequately control for potential confounders, such as age, menopausal status, alcohol use, and intake of the B-vitamin folate
These subgroups display differences in patient demographics, pathogenesis, prognosis and response to therapy