Mitochondrial arteriopathy, a suspected cause of spontaneous dissection of the internal carotid and vertebral arteries

Abstract

Dissection of the internal carotid artery and vertebral artery (ICA/VA) is one of the leading causes of ischaemic stroke in young people. The reason for the arterial wall weakness leading to its dissection remains unclear. Morphological study of the ICA/VA, and clinical data, indicate the presence of connective tissue dysplasia in patients, which is not associated with any known hereditary diseases. In this article, the authors summarize the results of their studies (histological and histochemical examination of muscle biopsies, electron microscopy of skin arteries) and observations (stroke-like episode, A3243G mutation in the mitochondrial genome in a patient with repeat ICA/VA dissections; increased peak lactate during MR spectroscopy in a patient who suffered an ICA dissection, then lobar hemorrhages a few years later). Based on these, the authors propose mitochondrial arteriopathy as the cause of arterial wall dysplasia leading to dissection. This article provides data on the presence of mitochondrial disorders in patients with ICA/VA dissection.

Keywords

• internal carotid artery dissection
• vertebral artery dissection
• mitochondrial disorders