Bilateral spontaneous dissection of the internal carotid arteries

Spontaneous dissections of the carotid or vertebral artery are an important cause of ischemic stroke in young and middleaged patients, accounting for 10–25% of such cases (Schievink, 2001). Between 9 and 21% of carotid dissectionsare bilateral (Zetterling et al., 2000) and the involvement of more than one artery suggests the presence of a transient arteriopathy. Current histological and biochemical data do not suggest only one form of disease, but rather various extracellular matrix abnormalities which may involve one of the fibrillar components or their enzymatic regulation.