TY - JOUR
AR - NNB-2018-1-101
TI - Spontaneous cervical artery dissection and prevalence of right-to-left shunt
AU - Donata , Guidetti
AU - Emanuele , Michieletti
AU - Eugenia , Rota
AU - Nicola, Morelli
JO - Neurology and Neurobiology
PY - 2018
DA - Fri 20, Apr 2018
SN - 2613-7828
DO - http://dx.doi.org/10.10xx/j.NNB.2018.10.001
UR - https://www.sciencerepository.org/spontaneous-cervical-artery-dissection-and-prevalence-of-right-to-left-shunt_NNB-1-101 
KW - right-to-left shunt, artery dissection, patent foramen ovale
AB - 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.