Arterial wall properties in multiple spontaneous cervical artery dissection. An ultrasound study.
Background: An underlying arteriopathy related to a generalized extracellular matrix defect is suspected in spontaneous cervical artery dissection. We selected patients with multiple spontaneous cervical artery dissection (MSCAD) to study carotid arteries morphology and common carotid arteries hemodynamic properties. Method: 12 patients with MSCAD (mean age 48±6, 50% of women) were consecutively and prospectively included during an eighteen month period and were compared with 12 ischemic stroke patients matched for age and sex. Cases and controls had ultrasound measurement of each common carotid artery diameter change in systole and diastole, during 3 to 5 cardiac cycles. This parameter was expressed as percentage. Post-processing of the ultrasonic signals was performed using computer-assisted image analysis. Results: There was no difference in diameter of common carotid and internal carotid arteries between cases and controls, just as intima-media thickness measurement. Whereas, the average of common carotid artery relative diameter change was significantly higher in cases than in controls (13.6% versus 10.6%, p=0.005) Conclusion: As common carotid artery relative diameter change is a one-dimensional assessment reflecting the elastic properties of the artery wall, our preliminary results suggest that an underlying arteriopathy may be present in multiple spontaneous cervical artery dissection.