title: Association between internal carotid artery dissection and arterial tortuosity.
abstract: BACKGROUND
  Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity.
  
  
  METHODS
  This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD.
  
  
  RESULTS
  Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively.
  
  
  CONCLUSIONS
  The presence of kinking and coiling is associated with ICAD.
authors.affiliation: Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554, 09045, Monserrato, Cagliari, Italy, lucasaba@tiscali.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Saba
authors.forename: Giovanni Maria
authors.initials: GM
authors.lastname: Argiolas
authors.forename: Suna
authors.initials: S
authors.lastname: Sumer
authors.forename: Paolo
authors.initials: P
authors.lastname: Siotto
authors.forename: Eytan
authors.initials: E
authors.lastname: Raz
authors.forename: Roberto
authors.initials: R
authors.lastname: Sanfilippo
authors.forename: Roberto
authors.initials: R
authors.lastname: Montisci
authors.forename: Mario
authors.initials: M
authors.lastname: Piga
authors.forename: Max
authors.initials: M
authors.lastname: Wintermark
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014102:Torsion Abnormality / Q000150:complications* / Q000175:diagnosis*; D055815:Young Adult