Familial occurrence and heritable connective tissue disorders in cervical artery dissection

Stéphanie Debette, Barbara Goeggel Simonetti, Sabrina Schilling, Juan José Martin, Manja Kloss, Hakan Sarikaya, Ingrid Hausser, Stefan Engelter, Tiina M. Metso, Alessandro Pezzini, Vincent Thijs, Emmanuel Touzé, Stefano Paolucci, Paolo Costa, Maria Sessa, Yves Samson, Yannick Béjot, Ayse Altintas, Antti J. Metso, Dominique HervéChristoph Lichy, Simon Jung, Urs Fischer, Chantal Lamy, Armin Grau, Hugues Chabriat, Valeria Caso, Philippe A. Lyrer, Christian Stapf, Turgut Tatlisumak, Tobias Brandt, Elisabeth Tournier-Lasserve, Dominique P. Germain, Michael Frank, Ralf W. Baumgartner, Caspar Grond-Ginsbach, Marie Germaine Bousser, Didier Leys, Jean Dallongeville, Anna Bersano, Marcel Arnold

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: In a large series of patients with cervical artery dissection (CeAD), a major cause of ischemic stroke in young and middle-aged adults, we aimed to examine frequencies and correlates of family history of CeAD and of inherited connective tissue disorders. Methods: We combined data from 2 large international multicenter cohorts of consecutive patients with CeAD in 23 neurologic departments participating in the CADISP-plus consortium, following a standardized protocol. Frequency of reported family history of CeAD and of inherited connective tissue disorders was assessed. Putative risk factors, baseline features, and 3-month outcome were compared between groups. Results: Among 1,934 consecutive patients with CeAD, 20 patients (1.0%, 95% confidence interval: 0.6%-1.5%) from 17 families (0.9%, 0.5%-1.3%) had a family history of CeAD. Family history of CeAD was significantly more frequent in patients with carotid location of the dissection and elevated cholesterol levels. Two patients without a family history of CeAD had vascular Ehlers-Danlos syndrome with a mutation in COL3A1. This diagnosis was suspected in 2 additional patients, but COL3A1 sequencing was negative. Two patients were diagnosed with classic and hypermobile Ehlers-Danlos syndrome, one patient with Marfan syndrome, and one with osteogenesis imperfecta, based on clinical criteria only. Conclusion: In this largest series of patients with CeAD to date, family history of symptomatic CeAD was rare and inherited connective tissue disorders seemed exceptional. This finding supports the notion that CeAD is a multifactorial disease in the vast majority of cases.

Original languageEnglish
Pages (from-to)2023-2031
Number of pages9
JournalNeurology
Volume83
Issue number22
DOIs
Publication statusPublished - Nov 1 2014

ASJC Scopus subject areas

  • Clinical Neurology

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