21 August 2019 : Case report
Unknown etiology, Challenging differential diagnosis, Unusual setting of medical careMalik Ghannam1ACD, Dana Ghazaleh23BE, Azizullah Beran4BE*, Benjamin Miller1EF, Brent Berry1CD
Am J Case Rep 2019; 20:1235-1240
BACKGROUND: Dissections occur when the intima is injured and an intramural hematoma develops between the intima and the media. There are a multitude of factors which contribute to arterial aneurysms and dissections, that could be infectious, genetic, traumatic, or environmental, but there are still cases for which the etiology is not determined.
CASE REPORT: We describe a patient who presented with arterial aneurysms and dissections that involved multiple vessels over the course of 10 years. We also reviewed the literature on possible risk factors, triggers, and genetic disorders that may predispose patients to developing arterial aneurysms and dissections.
CONCLUSIONS: To the best of our knowledge, this is the first report of this unusual pattern of presentation for idiopathic vasculopathy causing multiple dissections and aneurysms in a young patient. Idiopathic vasculopathy resulting in aneurysm and dissection is not an entirely uncommon entity; most cases of disparate dissection are not linked with a causal mechanism, although genetic influence is often heavily suspected, but it unfortunately often cannot be proven. We reviewed the available literature for a better understanding of pathologic, radiologic, and cytogenetic investigations of arteriopathy of unknown cause.
Keywords: Aneurysm, Dissecting, Aortic Aneurysm, Abdominal, Carotid Artery, Internal, Dissection, Adult, Aneurysm, Carotid Artery Diseases, Iliac Aneurysm, Magnetic Resonance Angiography, Mesenteric Artery, Superior
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