Association of cervical artery dissection with recent infection

被引:185
作者
Grau, AJ
Brandt, T
Buggle, F
Orberk, E
Mytilineos, J
Werle, E
Conradt, C
Krause, M
Winter, R
Hacke, W
机构
[1] Univ Heidelberg, Dept Neurol, D-69120 Heidelberg, Germany
[2] Univ Heidelberg, Dept Immunol, D-69120 Heidelberg, Germany
[3] Univ Heidelberg, Dept Med, D-69120 Heidelberg, Germany
[4] Univ Heidelberg, Dept Biomed Stat, D-69120 Heidelberg, Germany
关键词
D O I
10.1001/archneur.56.7.851
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Cervical artery dissection (CAD) is an important cause of ischemic stroke in younger patients. However, its cause is insufficiently understood. Objective: To test the hypothesis that CAD is frequently associated with recent infection. Subjects and Methods: We compared the prevalence of infection during the preceding week in 43 consecutive patients with acute CAD and 58 consecutive patients younger than 50 years with acute cerebral ischemia from other causes (control patients). In subgroups of patients, we correlated infectious status with electron microscopic studies of skin biopsy specimens and investigated pathways potentially linking infection and CAD. Results: Recent infection was more common in patients with CAD (25/43 [58.1%]) than in control patients (19/58 [32.8%]; P = .01). Respiratory tract infection was preponderant in both groups. Recent infection, but not the mechanical factors cough, sneezing, or vomiting, was independently associated with CAD in multivariate analysis. Investigation of serum antibodies against Chlamydia pneumoniae, smooth muscle cells, endothelial cells, collagen types I through IV, and heat shock protein 65 and assessment of serum alpha(1)-antitrypsin and HLA did not contribute to the understanding of the pathogenesis of CAD. More patients with pathologic findings in skin biopsy specimens tended to have had a recent infection (13/21 [62%]) than patients without pathologic findings (2/9 [22%]; P = .11). Conclusion: Our results suggest a significant association between recent infection and CAD that is not explained by mechanical factors occurring during infection.
引用
收藏
页码:851 / 856
页数:6
相关论文
共 46 条
  • [1] REVERSIBLE ANGIOPATHY
    ALPERT, JN
    GERSON, LP
    HALL, RJ
    HALLMAN, GL
    [J]. STROKE, 1982, 13 (01) : 100 - 105
  • [2] CAROTID-ARTERY DISSECTION WITH RENAL INFARCTS - 2 CASES
    AMARENCO, P
    SEUXLEVIEIL, ML
    COHEN, A
    LEVY, C
    TOUBOUL, PJ
    BOUSSER, MG
    [J]. STROKE, 1994, 25 (12) : 2488 - 2491
  • [3] CERVICOCRANIAL ARTERIAL DISSECTION
    ANSON, J
    CROWELL, RM
    [J]. NEUROSURGERY, 1991, 29 (01) : 89 - 96
  • [4] HUMAN-LEUKOCYTE ANTIGEN IN PATIENTS WITH MOYAMOYA DISEASE
    AOYAGI, M
    OGAMI, K
    MATSUSHIMA, Y
    SHIKATA, M
    YAMAMOTO, M
    YAMAMOTO, K
    [J]. STROKE, 1995, 26 (03) : 415 - 417
  • [5] BIDWELL J, 1988, IMMUNOL TODAY, V9, P1
  • [6] ISCHEMIC STROKE IN ADULTS YOUNGER THAN 30 YEARS OF AGE - CAUSE AND PROGNOSIS
    BOGOUSSLAVSKY, J
    REGLI, F
    [J]. ARCHIVES OF NEUROLOGY, 1987, 44 (05) : 479 - 482
  • [7] PRIMARY DISSECTING ANEURYSM OF EXTRACRANIAL PART OF INTERNAL CAROTID AND VERTEBRAL ARTERIES - A REPORT OF 3 CASES
    BOSTROM, K
    LILIEQUIST, B
    [J]. NEUROLOGY, 1967, 17 (02) : 179 - +
  • [8] Ultrastructural connective tissue abnormalities in patients with spontaneous cervicocerebral artery dissections
    Brandt, T
    Hausser, I
    Orberk, E
    Grau, A
    Hartschuh, W
    Anton-Lamprecht, I
    Hacke, W
    [J]. ANNALS OF NEUROLOGY, 1998, 44 (02) : 281 - 285
  • [9] DISSECTION OF THE INTRACRANIAL VERTEBRAL ARTERY
    CAPLAN, LR
    BAQUIS, GD
    PESSIN, MS
    DALTON, J
    ADELMAN, LS
    DEWITT, LD
    HO, K
    IZUKAWA, D
    KWAN, ES
    [J]. NEUROLOGY, 1988, 38 (06) : 868 - 877
  • [10] CAREY JL, 1994, CLIN LAB MED, P1599