Bum Joon Kim1, Ewha Yang1, Na-Young Kim1, Mi-Jung Kim1, Dong-Wha Kang1, Sun U Kwon1, Jong S Kim2. 1. From the Department of Neurology, Kyung Hee University Hospital, Kyung Hee University, College of Medicine, Seoul, Korea (B.J.K.); Department of Neurology, University of Ulsan (B.J.K., N.-Y.K., D.-W.K., S.U.K., J.S.K.), Health Screening and Promotion Center (M.-J.K.), and Asan Institute of Life Science (E.Y.), Asan Medical Center, Seoul, Korea. 2. From the Department of Neurology, Kyung Hee University Hospital, Kyung Hee University, College of Medicine, Seoul, Korea (B.J.K.); Department of Neurology, University of Ulsan (B.J.K., N.-Y.K., D.-W.K., S.U.K., J.S.K.), Health Screening and Promotion Center (M.-J.K.), and Asan Institute of Life Science (E.Y.), Asan Medical Center, Seoul, Korea. jongskim@amc.seoul.kr.
Abstract
BACKGROUND AND PURPOSE: Dissection is an increasingly recognized cause of ischemic stroke, which occurs spontaneously or after trauma, in relatively young patients. We hypothesized that there might be a predisposing factor weakening the vascular wall and that arterial tortuosity might be higher in patients with dissection. METHODS: We consecutively enrolled cervical artery dissection (CerAD) patients who had undergone magnetic resonance angiography. Age- and sex-matched healthy subjects who underwent magnetic resonance angiography in a routine health examination were used as controls. The tortuosity was measured semiautomatically from the carotid artery and vertebral artery (VA) arteries. Tortuosity index was defined as: [(arc/chord)-1×100] in each arteries. Independent risk factors associated with CerAD were investigated using multivariable analysis. Subgroup analysis according to the dissected artery was performed. RESULTS: There were no differences in vascular risk factors between the 75 CerAD patients and the 75 controls. The tortuosity indexes of the contralesional VA (16.3±6.8 versus 12.1±4.5, respectively; P<0.001) and carotid artery (8.8±4.0 versus 7.3±2.9, respectively; P=0.01) were higher in patients with CerAD compared with those of control subjects. VA tortuosity (odds ratio, 1.175; P=0.001) was independently associated with the presence of CerAD. In subgroup analysis, VA tortuosity was significantly higher in 57 patients with VA dissection than in controls (P<0.001), and carotid artery tortuosity was marginally higher in 18 patients with carotid artery dissection (P=0.05). CONCLUSIONS: CerAD is associated with tortuous cervical arteries, which may implicate weakened cervical vascular structure in these patients.
BACKGROUND AND PURPOSE: Dissection is an increasingly recognized cause of ischemic stroke, which occurs spontaneously or after trauma, in relatively young patients. We hypothesized that there might be a predisposing factor weakening the vascular wall and that arterial tortuosity might be higher in patients with dissection. METHODS: We consecutively enrolled cervical artery dissection (CerAD) patients who had undergone magnetic resonance angiography. Age- and sex-matched healthy subjects who underwent magnetic resonance angiography in a routine health examination were used as controls. The tortuosity was measured semiautomatically from the carotid artery and vertebral artery (VA) arteries. Tortuosity index was defined as: [(arc/chord)-1×100] in each arteries. Independent risk factors associated with CerAD were investigated using multivariable analysis. Subgroup analysis according to the dissected artery was performed. RESULTS: There were no differences in vascular risk factors between the 75 CerADpatients and the 75 controls. The tortuosity indexes of the contralesional VA (16.3±6.8 versus 12.1±4.5, respectively; P<0.001) and carotid artery (8.8±4.0 versus 7.3±2.9, respectively; P=0.01) were higher in patients with CerAD compared with those of control subjects. VA tortuosity (odds ratio, 1.175; P=0.001) was independently associated with the presence of CerAD. In subgroup analysis, VA tortuosity was significantly higher in 57 patients with VA dissection than in controls (P<0.001), and carotid artery tortuosity was marginally higher in 18 patients with carotid artery dissection (P=0.05). CONCLUSIONS:CerAD is associated with tortuous cervical arteries, which may implicate weakened cervical vascular structure in these patients.
Authors: G Adam; J Darcourt; M Roques; M Ferrier; R Gramada; Z Meluchova; S Patsoura; A Viguier; C Cognard; V Larrue; F Bonneville Journal: AJNR Am J Neuroradiol Date: 2020-01-16 Impact factor: 3.825
Authors: Evelien E de Vries; Vanessa E C Pourier; Constance J H C M van Laarhoven; Evert J Vonken; Joost A van Herwaarden; Gert J de Borst Journal: Neuroradiology Date: 2018-10-18 Impact factor: 2.804
Authors: Soledad Pérez-Sánchez; Ana Domínguez-Mayoral; Reyes De Torres-Chacón; Miguel A Gamero-García; Ana Barragán-Prieto; Irene Escudero-Martínez; Rafael F Ocete; Juan Herrero-Lara; Pilar Algaba; Francisco Moniche; Alejandro González; Luis Cueto; Joan Montaner Journal: J Int Med Res Date: 2020-03 Impact factor: 1.671