Open AccessImmunological mechanisms in multiple spontaneous cervical artery dissection: An illustrative case and review of the literature
Author(s) -
Zoltán Bajkó,
Smaranda Maier,
Anca Moţăţăianu,
Rareș Cristian Filep,
Adina Stoian,
Laura Bărcuţean,
Sebastian Andone,
Rodica Bălaşa
Publication year - 2021
Publication title -
romanian journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 4
eISSN - 2069-6094
pISSN - 1843-8148
DOI - 10.37897/rjn.2021.4.19
Subject(s) - cervical artery , etiology , medicine , pathogenesis , dissection (medical) , stroke (engine) , hyperhomocysteinemia , thrombophilia , disease , immunology , pathology , surgery , risk factor , thrombosis , mechanical engineering , engineering
Dissection of the cervical arteries is the leading cause of stroke in young adults, yet the etiology and pathogenesis of this event remain unclear. However, a growing number of data in the literature support the potential implications of immunological mechanisms in the pathogenesis. Several large patient groups and multicentre cohorts have reported significant associations with recent infections and elevated inflammatory markers. There are also several case reports and case series suggesting an association with various autoimmune disorders and viral infections. Some case reports have also detailed cervical artery dissections linked to the use of biological therapies for other pathologies. In the present case, a 38-year-old female patient with triple spontaneous cervical artery dissection presented multiple potential trigger factors as recent infection, autoimmune thyroid disease, primary thrombophilia and hyperhomocysteinemia. This report sought first presents this case, and then reviews the existing relevant literature data regarding the potential immunological mechanisms implicated in the pathogenesis of cervical artery dissection.