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Cervical Artery Dissection is Associated with Widened Aortic Root Diameter

Published online by Cambridge University Press:  18 September 2015

Vladimir Skljarevski ,
Michele Turek  and
Antoine M. Hakim
Vladimir Skljarevski*
Affiliation:
Divisions of Neurology, Ottawa Hospital- General Site, University of Ottawa, Ottawa.
Michele Turek
Affiliation:
Cardiology, Ottawa Hospital- General Site, University of Ottawa, Ottawa.
Antoine M. Hakim
Affiliation:
Divisions of Neurology, Ottawa Hospital- General Site, University of Ottawa, Ottawa.
*
Division of Neurology, Ottawa Hospital-General Site, , 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6
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Abstract:

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Objective:

Dissection of the internal carotid and vertebral arteries is a well recognized cause of stroke, especially in the middle-aged. The exact etiology of this condition is controversial. According to one theory there is an underlying vasculopathy originating from disturbed development of the neural crest. The neural crest gives rise to several tissues, including the tunica media of large cervical arteries and the outflow tract of the heart. We attempted to test the theory that developmental abnormality at the level of the neural crest may play a role in dissection of the large cervical arteries.

Methods:

We designed a retrospective case control study. By means of transthoracic echocardiography we measured the aortic root diameter in a group of patients with radiographically determined dissection of at least one large artery in the neck. The results were compared to a control group.

Results:

In comparison to age matched controls, male patients were found to have a significantly larger aortic root. Although a similar trend was apparent in females, the difference between the patient and control group of females was not statistically significant.

Conclusions:

Patients with cervical artery dissections may have other abnormalities in organs arising from the neural crest. A larger prospective clinical study and further research are needed to establish a firm link between dissection of the cervical arteries and abnormalities in other organs.

Résumé:

RÉSUMÉ: Objectif:

La dissection de la carotide interne et des artères vertébrales est une cause bien connue d'accident vasculaire cérébral, surtout dans la population d'âge moyen. L'étiologie exacte de cette condition est controversée. Une hypothèse propose qu'il existe une vasculopathie sous-jacente suite à un développement anormal de la crête neurale. La crête neurale donne naissance à plusieurs tissus, incluant la media des grosses artères cervicales et aux voies de chasse du coeur. Nous avons tenté de vérifier l'hypothèse selon laquelle une anomalie du développement au niveau de la crête neurale pourrait jouer un rôle dans la dissection des artères cervicales de gros calibre.

Méthodes:

Il s'agit d'une étude cas/témoins. Nous avons mesuré, au moyen de Péchocardiographie transthoracique, le diamètre de l'orig¬ine de l'aorte chez un groupe de patients ayant une dissection prouvée radiologiquement d'au moins une artère du cou de gros calibre. Les résultats ont été comparés à ceux obtenus chez un groupe contrôle

Résultats:

Dans le groupe expérimental d'hommes, l'origine de l'aorte était significativement plus large que dans le groupe contrôle apparié pour l'âge. Bien qu'une tendance était évidente chez les femmes, la différence entre le groupe expérimental et le groupe témoin n'était pas significative.

Conclusions:

Il est possible que les patients qui ont une dissection d'une artère cervicale aient également d'autres anomalies des organes qui proviennent de la crête neurale. Une étude prospective de plus grande envergure et des recherches plus poussées seront nécessaires pour établir un lien entre la dissection des artères cervicales et des anomalies d'autres organes.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 25 , Issue 4 , November 1998 , pp. 315 - 319
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

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