ИСТИНА

Background. Vascular wall weakness is considered to be a cause of the spontaneous cervical artery dissection (CeAD). Neck movements is a frequent provoking factor of the CeAD that allows to suggest that vascular wall weakness may be associated with decreased cervical artery elasticity. Aim: to study common carotid artery elasticity (CAE) in CeAD patients. Material and Methods. CAE was studied in 39 out of 192 CeAD patients examined at Research Center of Neurology, Moscow (26 females, 67%, mean age- 38.9±8.2 years). In all patients CeAD was verified by MRI/MRA. CAE was studied by ultrasound (Philips iU22, Philips iE33, Logiq 9), distensibility coefficient (DC), Young's elastic modulus (YEM) and stiffness index (SI) were calculated. Comparison group consisted of 27 patients with migraine as a primary disease; normal control group included 49 healthy subjects matched for age and sex. Results. Localization of the CeAD was as following: internal carotid artery (ICA) - 14 patients, vertebral artery (VA) – 20 patients, combination of ICA and VA dissection - 5 patients. CeAD manifested by ischemic stroke (n=20), TIA (n=1), isolated neck pain and/or headache (n=16), isolated lower cranial nerve palsy (n=2). Distensibility coefficient in patients with dissection (22.4 [13.8; 31.8]) was much less then in normal control (41.7 [31.3; 53.6] (p<0.001), whereas stiffness index and Young's elastic modulus were much higher than in control (6.9 [5.1; 10.1] vs 3.7 [2.9; 5.1] and 56.7 [32.2; 99.4]) vs 26.8 [19.0; 36.3], correspondingly, p<0.001). There was no difference of elasticity parameters between patients with ICA dissection and VA dissection. The comparison of CeAD patients and migraine patients demonstrated the same pattern as it was in comparison CeAD patient and normal control. Conclusion. Elasticity of common carotid artery in patients with CeAD is decreased comparing to healthy subjects and patients with primary migraine. The elasticity of ICA and VA appear to be also decreased as earler our morphological study found the similar changes in the wall of common carotid artery and ICA and VA. Decreased arterial wall elasticity may predispose to CeAD development in young patients.