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Vascular Tortuosity May Be Associated With Cervical Artery Dissection

Bum Joon Kim1, Ewha Yang1, Na-Young Kim1

  • 1From 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.

Stroke
|August 18, 2016
PubMed

Insights

Cervical artery dissection (CerAD) is linked to increased arterial tortuosity in younger patients. This finding suggests that a weakened vascular structure may predispose individuals to dissection, a cause of ischemic stroke.

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.
Abstract

Keywords:
dissectionmagnetic resonance angiographyrisk factorsstrokevertebral artery

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