Spontaneous cervical artery dissection and prevalence of right-to-left shunt

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Author Info

Donata Guidetti Emanuele Michieletti Eugenia Rota Nicola Morelli

Corresponding Author

Nicola Morelli
Neurology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy

A B S T R A C T

The pathogenesis of a spontaneous cervical artery dissection (sCAD) remains unknown. It has been hypothesized that most sCAD cases result from of a connective tissue disorder with a vascular phenotype. Collagen is the main component of some cardiac structures (such as the mitral, tricuspid and interatrial valves and interventricular septa). Therefore, assuming that anomalies of the connective tissue are involved in sCAD, we would expect to observe cardiac defects in patients with sCAD. The authors evaluated the prevalence of right-to-left shunt (RLS), due to a patent foramen ovale (PFO) in 52 patients with sCAD compared to 60 healthy subjects. RLS was assessed with transcranial Doppler contrast (TCDc) monitoring of the middle cerebral arteries. 42.3% of sCAD patients were positive to TCDc, whilst RLS was present in only 18.3% (p<0.05) of the control subjects, thus confirming that RLS is more prevalent in sCAD than in the general population. Our data might be the result of a common genetic substratum (involving alterations of connective tissue) that could lead on one hand to a predisposition for sCAD and, on the other, to endotelial/endocardiac alterations with persistence of the foramen ovale.

Article Info

Article Type

Research Article

Publication history

Received: Sat 23, Mar 2019
Accepted: Fri 13, Apr 2018
Published: Fri 20, Apr 2018

Copyright

© 2023 Nicola Morelli. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.10xx/j.NNB.2018.10.001