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Table of Contents
Vol. 17, No. 2-3, 2004
Issue release date: March 2004
Section title: Original Paper
Cerebrovasc Dis 2004;17:170–174
(DOI:10.1159/000075787)

Impairment of Endothelial Function in Patients with Spontaneous Cervical Artery Dissection: Evidence for a General Arterial Wall Disease

Lucas C.a · Lecroart J.L.b · Gautier C.b · Leclerc X.c · Dauzat M.d · Leys D.a · Deklunder G.b
Departments of aNeurology, bNeurosonology, and cNeuroradiology, Lille University Hospital, Lille, and dVascular Laboratory, Nîmes University Hospital, Nîmes, France

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 20, 2003
Accepted: July 17, 2003
Published online: December 23, 2003
Issue release date: March 2004

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 2

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED

Abstract

Background and Purpose: Cervical artery dissection (CAD) accounts for 10–20% of ischemic strokes in young adults. Although trauma and preexisting disorders of the arterial wall are the main predisposing factors, most CADs are considered ‘spontaneous’. We hypothesized that CAD could originate in systemic vascular disease bound to the intima–media interface without clinical signs. If this hypothesis is true, endothelium-dependent vasodilation would be impaired in response to a physiological stimulus such as an increase in blood flow. Methods: Flow-mediated arterial dilation was studied in 65 consecutive patients with spontaneous CAD: 26 with carotid artery dissection (ICAD), and 39 with vertebral artery dissection (VAD). CAD patients with vascular risk factors, trivial or obvious cervical trauma, or connective tissue disease were excluded. Twenty-three patients with ischemic stroke of unknown cause were included as controls. Using high-resolution ultrasonography, brachial artery diameter was measured at rest, during post-ischemic hyperemia (flow-mediated endothelium-dependent dilation), and after sublingual glyceryl trinitrate spray (endothelium-independent dilation). Results: The mean ± SD values of the flow-mediated vasodilation index were 5.7 ± 6.2% in ICAD, 5.0 ± 9.3% in VAD and 13.2 ± 6.5% in controls (p < 0.0005), without any difference between ICAD and VAD. Endothelium-independent dilation mean values were 21.5 ± 9.5% in ICAD, 25.1 ± 12.5% in VAD, and 20.8 ± 8.4% in controls, without a significant difference between groups (p = 0.49). Conclusions: These results give evidence of impaired endothelium-dependent vasodilation in CAD patients that is not the result of stroke, and suggest that an underlying abnormality of the arterial wall layers may predispose to CAD.

© 2004 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 20, 2003
Accepted: July 17, 2003
Published online: December 23, 2003
Issue release date: March 2004

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 2

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.