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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-24034

Callaghan, F M; Soellinger, M; Baumgartner, R W; Poulikakos, D; Boesiger, P; Kurtcuoglu, V (2009). The role of the carotid sinus in the reduction of arterial wall stresses due to head movements--potential implications for cervical artery dissection. Journal of Biomechanics, 42(6):755-761.

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Abstract

Spontaneous dissection of the cervical internal carotid artery (sICAD) is a major cause of stroke in young adults. A tear in the inner part of the vessel wall triggers sICAD as it allows the blood to enter the wall and develop a transmural hematoma. The etiology of the tear is unknown but many patients with sICAD report an initiating trivial trauma. We thus hypothesised that the site of the tear might correspond with the location of maximal stress in the carotid wall. Carotid artery geometries segmented from magnetic resonance images of a healthy subject at different static head positions were used to define a path of motion and deformation of the right cervical internal carotid artery (ICA). Maximum head rotation to the left and rotation to the left combined with hyperextension of the neck were investigated using a structural finite element model. A role of the carotid sinus as a geometrically compliant feature accommodating extension of the artery is shown. At the extreme range of the movements, the geometrical compliance of the carotid sinus is limited and significant stress concentrations appear just distal to the sinus with peak stresses at the internal wall on the posterior side of the vessel following maximum head rotation and on the anteromedial portion of the vessel wall following rotation and hyperextension. Clinically, the location of sICAD initiation is 10-30 mm distal to the origin of the cervical ICA, which corresponds with the peak stress locations observed in the model, thus supporting trivial trauma from natural head movements as a possible initiating factor in sICAD.

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Biomedical Engineering
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
DDC:170 Ethics
610 Medicine & health
Language:English
Date:2009
Deposited On:17 Nov 2009 12:49
Last Modified:27 Nov 2013 19:15
Publisher:Elsevier
ISSN:0021-9290
Publisher DOI:10.1016/j.jbiomech.2008.12.023
PubMed ID:19281988
Citations:Web of Science®. Times Cited: 4
Google Scholar™
Scopus®. Citation Count: 6

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