Connective tissue disorders in dissections of the carotid or vertebral arteries

Area of Science:

• Vascular Neurology
• Connective Tissue Diseases
• Genetics

Background:

• Cervical artery dissections (CAD) are a major cause of ischemic stroke in young adults.
• Etiologies include mechanical trauma and underlying arteriopathies, notably connective tissue disorders.

Purpose of the Study:

• To provide an overview of connective tissue disorders associated with carotid and vertebral artery dissections.
• To highlight the role of underlying arteriopathies in spontaneous dissections.

Main Methods:

• Literature review of studies on cervical artery dissections and connective tissue disorders.
• Analysis of etiological factors, including genetic and ultrastructural findings.

Main Results:

• Ehlers-Danlos syndrome type IV and other connective tissue disorders are significant risk factors for CAD.
• Dissections can occur spontaneously or after minor trauma, even in individuals without overt connective tissue disease.
• Ultrastructural connective tissue abnormalities are detectable in some patients with spontaneous dissections.

Conclusions:

• Connective tissue disorders represent a crucial, often underdiagnosed, etiology for carotid and vertebral artery dissections.
• Recognition of these disorders is vital for appropriate patient management and genetic counseling.