CERVICAL ARTERY DISSECTION IS ASSOCIATED WITH WIDENED AORTIC ROOT DIAMETER

Objective: Dissection of the internal carotid and vertebral arteries i s a well recognized cause of stroke, especially in the middle-aged. Th e exact etiology of this condition is controversial. According to one theory there is an underlying vasculopathy originating from disturbed development of the neural crest. The neural crest gives rise to severa l tissues, including the tunica media of large cervical arteries and t he outflow tract of the heart. We attempted to test the theory that de velopmental abnormality at the level of the neural crest may play a ro le in dissection of the large cervical arteries. Methods: We designed a retrospective case control study. By means of transthoracic echocard iography we measured the aortic root diameter in a group of patients w ith radiographically determined dissection of at least one large arter y in the neck. The results were compared to a control group. Results: In comparison to age matched controls, male patients were found to hav e a significantly larger aortic root. Although a similar trend was app arent in females, the difference between the patient and control group of females was not statistically significant. Conclusions: Patients w ith cervical artery dissections may have other abnormalities in organs arising from the neural crest. A larger prospective clinical study an d further research are needed to establish a firm link between dissect ion of the cervical arteries and abnormalities in other organs.