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Neurology 2000;55:663-666
© 2000 American Academy of Neurology
Articles

Arterial wall properties in carotid artery dissection

An ultrasound study

B. Guillon, MD, C. Tzourio, MD, PhD, V. Biousse, MD, V. Adraï, MD, M. G. Bousser, MD and P. J. Touboul, MD

From the Service de Neurologie (Dr. Guillon), Hôpital Laënnec, Nantes; INSERM U360 (Dr. Tzourio), Hôpital de la Salpêtrière, Paris; and Service de Neurologie (Drs. Tzourio, Biousse, Adraï, Bousser, and Touboul), Hôpital Lariboisière, Paris, France.

Address correspondence and reprint requests Dr. C. Tzourio, INSERM U360, Hôpital de la Salpêtrière, 75651 Paris cedex 13, France; e-mail: tzourio{at}chups.jussieu.fr

BACKGROUND: Cervical artery dissection is often attributed to an underlying arteriopathy related to a generalized extracellular matrix defect.

OBJECTIVE: The authors compared the hemodynamic and morphologic properties of the carotid artery, as assessed noninvasively by ultrasonography, in patients with spontaneous internal carotid artery dissection (ICAD) and control subjects.

METHOD: Twenty-six patients who experienced ICAD more than 6 months before evaluation were compared with 26 controls matched for age, sex, and height. Cases and controls had ultrasound measurement of common carotid artery diameter and diameter change during the cardiac cycle, bulbar and suprabulbar internal carotid artery diameters, and common carotid artery intima–media thickness. The unaffected carotid artery in cases was compared with the carotid artery of the same side in controls.

RESULTS: Common carotid artery relative diameter change was significantly higher in cases than controls, whereas other measurements were not significantly different between the groups. In multivariate analyses, the highest tertile of common carotid artery relative diameter change was associated with the risk of ICAD (OR, 10.0; 95% CI, 1.8 to 54.2; p = 0.002)

CONCLUSION: An underlying arteriopathy, presumably related to an extracellular matrix defect, may be present in patients with spontaneous ICAD.




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