Vascular Tortuosity May Be Associated With Cervical Artery Dissection

Area of Science:

• Neurology
• Vascular Biology
• Medical Imaging

Background:

• Cervical artery dissection (CerAD) is an emerging cause of ischemic stroke in young individuals.
• Spontaneous or trauma-induced CerAD may be linked to underlying vascular wall weaknesses.
• Arterial tortuosity is investigated as a potential predisposing factor for CerAD.

Purpose of the Study:

• To investigate the association between arterial tortuosity and cervical artery dissection.
• To identify predisposing factors for CerAD, particularly vascular wall characteristics.
• To compare tortuosity in cervical arteries of CerAD patients and healthy controls.

Main Methods:

• Magnetic resonance angiography (MRA) was used to assess cervical arteries in 75 CerAD patients and 75 matched controls.
• Semiautomated measurement of carotid and vertebral artery (VA) tortuosity using a standardized index.
• Multivariable analysis to identify independent risk factors for CerAD, with subgroup analysis based on the dissected artery.

Main Results:

• No significant differences in traditional vascular risk factors were found between CerAD patients and controls.
• Higher tortuosity indexes were observed in the contralesional vertebral artery (P<0.001) and carotid artery (P=0.01) of CerAD patients.
• Vertebral artery tortuosity was an independent predictor of CerAD (OR, 1.175; P=0.001), with significantly higher tortuosity in VA dissection subgroups.

Conclusions:

• Cervical artery dissection is associated with increased tortuosity in cervical arteries.
• This association suggests that inherent weaknesses in cervical vascular structure may play a role in the pathogenesis of CerAD.
• Arterial tortuosity is a potential biomarker for individuals at risk of cervical artery dissection.