title: Spontaneous Bilateral Cervical Internal Carotid and Vertebral Artery Dissection in a Japanese Patient without Collagen Vascular Disease with Special Reference to Single-Nucleotide Polymorphisms.
abstract: Spontaneous cervical artery dissection (sCAD) is a major cause of ischemic stroke in young adults. Frequently, sCAD involves multiple neck arteries, accounting for 13%-28% of the total sCAD cases. However, little is known about factors related to multiple sCAD. In this case, a 52-year-old man was admitted due to headache without aura. There was a personal history of migraine with aura and a family history of similar symptoms. The patient's younger brother had a left vertebral artery (VA) dissecting aneurysm and underwent endovascular occlusion of his parent artery at the age of 48. Magnetic resonance imaging of our admitted patient showed hyperintensities in the right internal carotid artery (ICA) without acute infarction, and magnetic resonance angiography revealed a narrowing of the right ICA. Angiography was then performed, which showed a trace of dissection of the left ICA and both VAs as well as the right ICA. The patient did not fulfill any major criteria of collagen vascular disease such as Ehlers-Danlos syndrome type IV or Loeys-Dietz syndrome. The data in our patient are quite similar to those reported in patients with single-nucleotide polymorphism (SNP) of PHACTR1. Obtaining the patient's informed consent, we analyzed a common SNP variation in the rs9349379[G] allele (PHACTR1), which has been reported to be associated with a lower risk of sCAD.
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan. Electronic address: abe@nms.ac.jp.
authors.forename: Arata
authors.initials: A
authors.lastname: Abe
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Nito
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sakamoto
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Akane
authors.initials: A
authors.lastname: Nogami
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hokama
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kirita
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ueda
authors.affiliation: Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Ishimaru
authors.affiliation: Department of Neuro-pathophysiological Imaging, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
mesh_terms: D044466:Asian People; D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics*; D003094:Collagen / Q000235:genetics*; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D020217:Vertebral Artery Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics*
chemical_list: D003094:Collagen
keywords: Carotid artery dissection; PHACTR1; migraine; vertebral artery dissection