title: Cervical artery tortuosity is associated with intracranial aneurysm.
abstract: Background Intracranial aneurysms may be associated with an underlying arteriopathy, leading to arterial wall fragility. Arterial tortuosity is a major characteristic of some connective tissue disease. Aim To determine whether intracranial aneurysm is associated with an underlying arteriopathy. Methods Using a case-control design, from May 2012 to May 2013, we selected intracranial aneurysm cases and controls from consecutive patients who had conventional cerebral angiography in our center. Cases were patients with newly diagnosed intracranial aneurysm. Controls were patients who had diagnostic cerebral angiography and free of aneurysm. The prevalence of tortuosity, retrospectively assessed according to standard definitions, was compared between cases and controls and, association between tortuosity and some aneurysm characteristics was examined, in cases only. Results About 659 arteries from 233 patients (112 cases and 121 controls) were examined. Tortuosity was found in 57 (51%) cases and 31 (26%) controls (adjusted OR = 2.71; 95%CI, 1.53-4.80). The same trend was found when looking at each tortuosity subtype (simple tortuosity, coil, kink) or at carotid or vertebral territory separately. In contrast, no association between tortuosity and rupture status, aneurysm number or neck size was found. Conclusions Cervical artery tortuosity is significantly associated with intracranial aneurysm, although not related to main aneurysm characteristics. Our results support the presence of an underlying diffuse arteriopathy in intracranial aneurysm patients.
authors.affiliation: 1 Normandie Université, Unicaen, France.|2 Department of Radiology, Centre Hospitalier Universitaire de Caen (CHU Caen), Caen, France.|3 Departement of Inteventional Neuroradiology, Hospices Civils, Lyon, France.|4 Inserm U919, Caen, France.
authors.forename: Paul-Emile
authors.initials: PE
authors.lastname: Labeyrie
authors.affiliation: 2 Department of Radiology, Centre Hospitalier Universitaire de Caen (CHU Caen), Caen, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Braud
authors.affiliation: 1 Normandie Université, Unicaen, France.|4 Inserm U919, Caen, France.|5 Department of Anesthesiology, CHU Caen, Caen, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Gakuba
authors.affiliation: 1 Normandie Université, Unicaen, France.|4 Inserm U919, Caen, France.|6 Department of Neurosurgery, CHU Caen, Caen, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gaberel
authors.affiliation: 4 Inserm U919, Caen, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Orset
authors.affiliation: 4 Inserm U919, Caen, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Goulay
authors.affiliation: 1 Normandie Université, Unicaen, France.|4 Inserm U919, Caen, France.|6 Department of Neurosurgery, CHU Caen, Caen, France.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Emery
authors.affiliation: 1 Normandie Université, Unicaen, France.|2 Department of Radiology, Centre Hospitalier Universitaire de Caen (CHU Caen), Caen, France.|4 Inserm U919, Caen, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Courthéoux
authors.affiliation: 1 Normandie Université, Unicaen, France.|4 Inserm U919, Caen, France.|7 Department of Neurology, Stroke Unit, CHU Caen, Caen, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Touzé
mesh_terms: D015901:Angiography, Digital Subtraction; D001158:Arteries / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D007593:Joint Instability / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012873:Skin Diseases, Genetic / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D054079:Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology
keywords: Intracranial aneurysm; arterial tortuosity; connective tissue disease; fibromuscular dysplasia; subarachnoid hemorrhage