Connective tissue anomalies in patients with spontaneous cervical artery dissection

Giossi, Alessia; Ritelli, Marco; Costa, Paolo; Morotti, Andrea; Poli, Loris; Zotto, Elisabetta Del; Volonghi, Irene; Chiarelli, Nicola; Gamba, Massimo; Bovi, Paolo; Tomelleri, Giampaolo; Carletti, Monica; Checcarelli, Nicoletta; Meneghetti, Giorgio; Morra, M; Chinaglia, Mauro; Giuli, Valeria De; Colombi, Marina; Padovani, Alessandro; Pezzini, Alessandro

doi:10.1212/wnl.0000000000001030

Cited by 44 publications

(31 citation statements)

References 9 publications

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“…However, cases to date of confirmed Marfan syndrome and carotid or vertebral artery dissection are almost always in the presence of prior aortic dissection or surgery [160,161]. In two studies systemically evaluating 84 and 43 patients, respectively, with spontaneous cervical artery dissection, none had Marfan syndrome [162,163]. In a large study of 1,934 consecutive patients with cervical artery dissection specifically evaluating for inherited connective tissue disease, only one had clinical Marfan syndrome; FBN1 testing was not performed [157].…”

Section: Spontaneous Cervical Artery Dissectionmentioning

confidence: 99%

Features of Marfan syndrome not listed in the Ghent nosology – the dark side of the disease

Kodolitsch

Demolder

Girdauskas

et al. 2019

Expert Review of Cardiovascular Therapy

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Introduction: The revised Ghent nosology presents the classical features of Marfan syndrome. However, behind its familiar face, Marfan syndrome hides less well-known features. Areas covered: The German Marfan Organization listed unusual symptoms and clinical experts reviewed the literature on clinical features of Marfan syndrome not listed in the Ghent nosology. Thereby we identified the following features: (1) bicuspid aortic valve, mitral valve prolapse, pulmonary valve prolapse, tricuspid valve prolapse, (2) heart failure and cardiomyopathy, (3) supraventricular arrhythmia, ventricular arrhythmia, and abnormal repolarization, (4) spontaneous coronary artery dissection, anomalous coronary arteries, and atherosclerotic coronary artery disease, tortuosity-, aneurysm-, and dissection of large and medium-sized arteries, (5) restrictive lung disease, parenchymal lung disease, and airway disorders, (6) obstructive-and central sleep apnea, (7) liver and kidney cysts, biliary tract disease, diaphragmatic hernia, and adiposity, (8) premature labor, and urinary incontinence, (9) myopathy, reduced bone mineral density, and craniofacial manifestations, (10) atrophic scars, (11) caries, and craniomandibular dysfunction, (12) headache from migraine and spontaneous cerebrospinal fluid leakage, (13) cognitive dysfunction, schizophrenia, depression, fatigue, and pain, (14) and activated fibrinolysis, thrombin, platelets, acquired von Willebrand disease, and platelet dysfunction. Expert commentary: Future research, nosologies, and guidelines may consider less well-known features of Marfan syndrome. ARTICLE HISTORY

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Section: Spontaneous Cervical Artery Dissectionmentioning

confidence: 99%

Features of Marfan syndrome not listed in the Ghent nosology – the dark side of the disease

Kodolitsch

Demolder

Girdauskas

et al. 2019

Expert Review of Cardiovascular Therapy

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“…54,55 Patients with cervical arterial dissection are also more likely to have clinically detectable connective tissue abnormalities, such as joint laxity or hyperextension. 56 Case-control studies in adults provide evidence of an association between minor acute infection and arterial dissection. 57,58 Taken together, these studies support the hypothesis that environmental exposures like trauma and infection can act as triggers for arteriopathy (in this case, dissection) in the genetically predisposed.…”

Section: Traumamentioning

confidence: 99%

Genetic and Environmental Associations With Pediatric Cerebral Arteriopathy

McCrea

Fullerton

Ganesan³

2019

Stroke

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“…17 Recent studies have shown that patients with CAD often have clinical features of connective tissue abnormalities 137 but rarely meet criteria for established hereditary connective tissue diseases. 137,138 Furthermore, most publications included in our study did not contain specific information about the presence or absence of migraine, which was recently suggested to be a synergistic factor in the pathogenesis of CAD in young stroke patients. 139 With regard to anatomical parameters, it has been noted that arterial tortuosity is more prevalent among CAD patients than among matched controls.…”

Section: Parameters Not Included In the Analytical Evaluationmentioning

confidence: 99%

Cervical artery dissection after sports – An analytical evaluation of 190 published cases

Schlemm

Nolte

Engelter

et al. 2017

European Stroke Journal

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Introduction: Cervical artery dissections may be preceded by mechanical trigger events, often related to sports. Methods: Using the MEDLINE database, we identified case reports and case series of sports-related cervical artery dissections. Information of the type of sport, age and gender of the patient, affected vessels, associated infarction, time delay, and neurological sequelae were extracted. Demographic and clinical characteristics were compared between sport groups using analysis of variance and Chi square tests. Differences were further assessed with adjusted post hoc tests and homogenous subsets. Results: A total of 115 reports describing 190 patients with cervical artery dissections related to 45 different sports were identified. The mean age of all patients was 35 years; 26% of all patients were women. Anterior and posterior circulation, as well as left and right side were affected with similar frequency. Patients belonging to different sport categories differed significantly with regard to age (p < 0.001), gender (p < 0.001), and affected circulation (anterior vs. posterior, p ¼ 0.02). The posterior circulation was most often affected in golf players (88%) and least often in individuals engaging in exercise (23%) and scuba divers (29%). Laterality (left vs. right) and mortality were similar between sport groups. Discussion: We performed a comprehensive review and analytical evaluation of case reports describing patients with cervical artery dissections after sport. Confirmation of our findings in prospective studies is needed. Conclusion: Cervical artery dissection has been described in relation to a wide variety of sports. The risk of injury to particular neurovascular structures may depend on the type sport involved. Discipline-specific incidence rates are not known.

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Connective tissue anomalies in patients with spontaneous cervical artery dissection

Cited by 44 publications

References 9 publications

Features of Marfan syndrome not listed in the Ghent nosology – the dark side of the disease

Features of Marfan syndrome not listed in the Ghent nosology – the dark side of the disease

Genetic and Environmental Associations With Pediatric Cerebral Arteriopathy

Cervical artery dissection after sports – An analytical evaluation of 190 published cases

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