Generalized arteriopathy in patients with cervical artery dissection.
OBJECTIVE
To make an ultrastructural comparison of superficial temporal artery (STA) biopsy specimens from patients with spontaneous cervical artery dissection (sCAD) and controls.


METHODS
The authors used light microscopic examination of semithin sections and electron microscopic examination of ultrathin sections of STA biopsy specimens from patients with sCAD and controls.


RESULTS
STA biopsy specimens from patients with sCAD taken around the time of the dissection showed a zone of connective tissue weakening with fissuring at the junction between the tunica media (TM) and the tunica adventitia (TA) in seven of nine specimens and erythrocyte infiltration in eight of nine specimens but in none of the control specimens. Light microscopy demonstrated transparent circular spots that, on electron microscopy, turned out to represent erythrocytes and other cellular components at different stages of degradation. Occasionally, scattered immune cells were found in specimens from patients with sCAD. In addition, smooth muscle cells of the synthetic phenotype, some of them showing extensive vacuolation were more common in the TM of STA biopsy specimens from patients with sCAD than in control specimens.


CONCLUSIONS
Signs of tissue weakening along the TM/TA junction in STA biopsy specimens of patients with sCAD but not in controls suggest the presence of a generalized arteriopathy leading to impairment of the stability of the arterial wall in patients with sCAD. Limiting factors of the study are that some control biopsies were obtained from autopsies and that the anticoagulation status of patients and controls were not completely comparable.
Völker
W
W
Institute of Atherosclerosis Research, University of Münster, Münster, Germany.
Besselmann
M
M
Dittrich
R
R
Nabavi
D
D
Konrad
C
C
Dziewas
R
R
Evers
S
S
Grewe
S
S
Krämer
S C
SC
Bachmann
R
R
Stögbauer
F
F
Ringelstein
E B
EB
Kuhlenbäumer
G
G
D000328:Adult; D001706:Biopsy; D020215:Carotid Artery, Internal, Dissection / Q000473:pathology* / Q000503:physiopathology; D003094:Collagen / Q000648:ultrastructure; D003095:Collagen Diseases / Q000150:complications; D003238:Connective Tissue / Q000473:pathology / Q000503:physiopathology / Q000648:ultrastructure; D004912:Erythrocytes / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D013699:Temporal Arteries / Q000473:pathology* / Q000503:physiopathology / Q000648:ultrastructure; D017540:Tunica Media / Q000473:pathology / Q000503:physiopathology / Q000648:ultrastructure; D020217:Vertebral Artery Dissection / Q000473:pathology* / Q000503:physiopathology
D003094:Collagen