RESUMEN
Swifts (Apodidae) are an unusual group of birds that spend most of their lives in flight, landing only when breeding. Although this aerial lifestyle greatly reduces their likelihood of being bitten by vectors and infected by vector-born parasites, swifts can still be heavily infested during breeding by nest-based vectors such as louse flies (Hippoboscidae). Here, we investigated host, vector, and vector-borne parasite relationships in the three most widespread swift species in the Western Palearctic (WP): common swifts (Apus apus), pallid swifts (A. pallidus), and alpine swifts (Tachymarptis melba), their nest-based louse flies (Crataerina pallida and C. melbae) and avian haemosporidians (genera Haemoproteus, Plasmodium, and Leucocytozoon). Studies of haemosporidian infections in Apodidae remain limited, with clear evidence of infection found to date in just four Neotropical and one Australasian species. The possible role of louse flies in transmitting haemosporidian infections has never been tested in swifts. We assessed the occurrence of haemosporidian infection by PCR screenings of DNA from blood samples from 34 common swifts and 44 pallid swifts from Italy, and 45 alpine swifts from Switzerland. We also screened 20 ectoparasitic louse flies present on 20 birds and identified them by both morphological features and cytochrome oxidase subunit 1 (COI) barcodes. Our results provide no evidence of haemosporidian infection in the 123 swifts tested or in the two louse fly species we identified. Our findings are consistent with available knowledge showing no haemosporidian occurrence in WP swift species and that the most likely infection route for these highly aerial species (via louse fly ectoparasites during nesting) is unlikely.
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Anoplura , Enfermedades de las Aves , Dípteros , Infestaciones Ectoparasitarias , Haemosporida , Animales , Dípteros/parasitología , Enfermedades de las Aves/parasitología , Infestaciones Ectoparasitarias/parasitología , Aves/parasitología , Haemosporida/genética , FilogeniaRESUMEN
Investigation of ecological responses of species to past climate oscillations provides crucial information to understand the effects of global warming. In this work, we investigated how past climate changes affected the distribution of six bird species with different climatic requirements and migratory behaviours in the Western Palearctic and in Africa. Species Distribution Models and Marine Isotopic Stage (MIS) 2 fossil occurrences of selected species were employed to evaluate the relation between changes in range size and species climatic tolerances. The Last Glacial Maximum (LGM) range predictions, generally well supported by the MIS 2 fossil occurrences, suggest that cold-dwelling species considerably expanded their distribution in the LGM, experiencing more pronounced net changes in range size compared to temperate species. Overall, the thermal niche proves to be a key ecological trait for explaining the impact of climate change in species distributions. Thermal niche is linked to range size variations due to climatic oscillations, with cold-adapted species currently suffering a more striking range reduction compared to temperate species. This work also supports the persistence of Afro-Palearctic migrations during the LGM due to the presence of climatically suitable wintering areas in Africa even during glacial maxima.
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Cambio Climático , Ecosistema , África , Animales , Aves , FilogeografíaRESUMEN
Several large-bodied hominin and nonhuman primates have coexisted in the Cradle of Humankind in South Africa during the Early Pleistocene. Previous paleoenvironmental studies regarding the Plio-Pleistocene of South Africa have focused heavily on mammal assemblages. Here, we conducted a comprehensive taxonomic analysis of the fossil bird remains from Cooper's D, the most fossiliferous locality of the hominin-bearing Cooper's Cave complex in South Africa. Our taxonomic evaluation of 505 remains reveals the presence of 23 bird taxa, two of which are extinct and already reported from the nearby fossil locality of Kromdraai. The taxonomically diverse bird assemblage is dominated by Francolinus sp. and other species associated with open grassland habitats, followed by rock-dwelling species, including Tyto cf. alba and the extinct Corvus bragai, and by woodland species such as Agapornis sp., Accipiter melanoleucos, and the extinct Glaucidium ireneae. The occurrence of these taxa and their respective proportions in the assemblage, in terms of both numbers of bones and individuals, point to the presence of extensive open grassland and/or savannah with rocky outcrops and woodland. These findings corroborate previous analyses of mammals from Cooper's D, with the exception of aquatic species, which are rare in the bird assemblage. Comparison with older deposits from Kromdraai confirms the definitive establishment of open habitats in the Cradle of Humankind during the Early Pleistocene following a transition from woodier habitats during the Late Pliocene. This study constitutes a further step in investigating the fossil bird diversity in the Cradle of Humankind during the Plio-Pleistocene. Our results add to the larger body of work using avian fossils for paleoenvironmental reconstructions in Africa and support the utility of birds as paleoenvironmental proxies. Similar future studies will refine our understanding of the paleoenvironments and landscape transformation during the Plio-Pleistocene, a critical timeframe for hominin evolution in southern Africa.
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Fósiles , Hominidae , Animales , Aves , Mamíferos , SudáfricaRESUMEN
BACKGROUND: The Careggi Collateral Score (CCS) (qualitative-quantitative evaluation) was developed from a single-centre cohort as an angiographic score to describe both the extension and effectiveness of the pial collateral circulation in stroke patients with occlusion of the anterior circulation. We aimed to examine the association between CCS (quantitative evaluation) and 3-month modified Rankin Scale (mRS) score in a large multi-center cohort of patients receiving thrombectomy for stroke with occlusion of middle cerebral artery (MCA). METHODS: We conducted a study on prospectively collected data from 1284 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. According to the extension of the retrograde reperfusion in the cortical anterior cerebral artery (ACA)-MCA territories, CCS ranges from 0 (absence of retrograde filling) to 4 (visualization of collaterals until the alar segment of the MCA). RESULTS: Using CCS of 4 as reference, CCS grades were associated in the direction of unfavourable outcome on 3-month mRS shift (0 to 6); significant difference was found between CCS of 0 and CCS of 1 and between CCS of 3 and CCS of 4. CCS ≥ 3 was the optimal cut-off for predicting 3-month excellent outcome, while CCS ≥ 1 was the optimal cut-off for predicting 3-month survival. CCS of 0 and CCS < 3 were associated in the direction of unfavourable recanalization on TICI shift (0 to 3) compared with CCS ≥ 1 and CCS ≥ 3, respectively. Compared with CCS ≥ 3 as reference, CCS of 0 and CCS 1 to 2 were associated in the direction of unfavourable recanalization on TICI shift. There was no evidence of heterogeneity of effects of successful recanalization and procedure time ≤ 60 min on 3-month mRS shift across CCS categories. CONCLUSION: The CCS could provide a future advantage for improving the prognosis in patients receiving thrombectomy for stroke with M1 or M1-M2 segment of the MCA occlusion.
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Procedimientos Endovasculares , Accidente Cerebrovascular , Angiografía Cerebral , Humanos , Infarto de la Arteria Cerebral Media/diagnóstico por imagen , Infarto de la Arteria Cerebral Media/cirugía , Arteria Cerebral Media/diagnóstico por imagen , Arteria Cerebral Media/cirugía , Estudios Retrospectivos , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/cirugía , Trombectomía , Resultado del TratamientoRESUMEN
Baleen whales are considered underencephalized mammals due to their reduced brain size with respect to their body size (encephalization quotient [EQ] << 1). Despite their low EQ, mysticetes exhibit complex behavioral patterns in terms of motor abilities, vocal repertoire, and cultural learning. Very scarce information is available about the morphological evolution of the brain in this group; this makes it difficult to investigate the historical changes in brain shape and size in order to relate the origin of the complex mysticete behavioral repertoire to the evolution of specific neural substrates. Here, the first description of the virtual endocast of a fossil balaenopterid species, Marzanoptera tersillae from the Italian Pliocene, reveals an EQ of around 3, which is exceptional for baleen whales. The endocast showed a morphologically different organization of the brain in this fossil whale as the cerebral hemispheres are anteroposteriorly shortened, the cerebellum lacks the posteromedial expansion of the cerebellar hemispheres, and the cerebellar vermis is unusually reduced. The comparative reductions of the cerebral and cerebellar hemispheres suggest that the motor behavior of M. tersillae probably was less sophisticated than that exhibited by the extant rorqual and humpback species. The presence of an EQ value in this fossil species that is around 10 times higher than that of extant mysticetes opens new questions about brain evolution and provides new, invaluable information about the evolutionary path of morphological and size change in the brain of baleen whales.
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Fósiles , Ballenas , Animales , Evolución Biológica , Encéfalo , MaxilaresRESUMEN
BACKGROUND: The flow-diverter devices (FDDs) safety and effectiveness have been demonstrated by large series and meta-analyses. Due to the high occlusion rates and the acceptable morbidity rates of FDDs, the indications for their use are continuously expanding. We presented our Italian multicentric experience using the second generation of DERIVO® Embolization Device (DED®; Acandis, Pforzheim, Germany) to cure cerebral aneurysms, evaluating both middle and long-term safety and efficacy of this device. METHODS: Between July 2016 and September 2017 we collected 109 consecutive aneurysms in 108 patients treated using DED® during 109 endovascular procedures in 34 Italian centers (100/109 aneurysms were unruptured, 9/109 were ruptured). The collected data included patient demographics, aneurysm location and characteristics, baseline angiography, adverse event and serious adverse event information, morbidity and mortality rates, and pre- and post-treatment modified Rankin Scale scores. Midterm and long-term clinical, angiographic and cross-sectional CT/MR follow-up were recorded and collected until December 2018. RESULTS: In 2/109 cases, DED® placement was classified as technical failures. The overall mortality and morbidity rates were respectively 6.5% and 5.5%. Overall DERIVO® related mortality and morbidity rates were respectively 0% and 4.6% (5 out of 108 patients). Midterm neuroimaging follow-up showed the complete or nearly complete occlusion of the aneurysm in 90% cases, which became 93% at long-term follow-up. Aneurysmal sac shrinking was observed in 65% of assessable aneurysms. CONCLUSIONS: Our multicentric experience using DED® for endovascular treatment of unruptured and ruptured aneurysms showed a high safety and efficacy profile, substantially equivalent or better compared to the other FDDs.
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Embolización Terapéutica , Procedimientos Endovasculares , Aneurisma Intracraneal , Angiografía Cerebral , Estudios de Seguimiento , Humanos , Aneurisma Intracraneal/terapia , Italia , Sistema de Registros , Estudios Retrospectivos , Stents , Resultado del TratamientoRESUMEN
The natural endocast Museo di Geologia e Paleontologia of the Università degli Studi di Torino (MGPT)-PU 13873 is described and analyzed in order to interpret its taxonomic affinities and its potential significance on our understanding of cetacean brain evolution. The endocast is from the early Miocene of Piedmont (between ca. 19 and 16 million years ago), Northwestern Italy, and shows a number of plesiomorphic characters. These include: scarcely rounded cerebral hemispheres, cerebellum exposed in dorsal view with little superimposition by the cerebral hemispheres, short temporal lobe, and long sylvian fissure. The distance between the hypophysis and the rostral pons is particularly high, as it was determined by the calculus of the hypothalamus quotient, suggesting that the development of a deep interpeduncular fossa was not as advanced as in living odontocetes. The encephalization quotient (EQ) of MGPT-PU 13873 is ~1.81; therefore, this specimen shows an EQ in line with other fossil whales of the same geological age (early Miocene). Comparative analysis shows that there is a critical lack of data from the late Miocene and Pliocene that prevents us to fully understand the recent evolution of the EQ diversity in whales. Moreover, the past diversity of brain size and shape in mysticetes is virtually unknown. All these observations point to the need of additional efforts to uncover evolutionary patterns and processes on cetacean brain evolution.
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Evolución Biológica , Encéfalo/anatomía & histología , Cetáceos/anatomía & histología , Fósiles/anatomía & histología , Animales , Encéfalo/irrigación sanguínea , Encéfalo/fisiología , Cetáceos/fisiologíaRESUMEN
The correct affiliation of Sabrina Lo Brutto is shown in this paper.
Asunto(s)
Contaminantes Ambientales , Rapaces , Animales , Monitoreo del Ambiente , Europa (Continente)RESUMEN
The Common Chiffchaff Phylloscopus collybita is an abundant, polytypic Palearctic bird. Validity of some of its subspecies is controversial and birds from some parts of the species range remain unclassified taxonomically. The relationships among populations from different geographic areas have not been sufficiently explored with molecular data. In this study we analyzed the relationships among the four species in the 'chiffchaff complex' (Common Chiffchaff, Iberian Chiffchaff P. ibericus, Canary Islands Chiffchaff P. canariensis and Mountain Chiffchaff P. sindianus), and the patterns of intraspecific geographic variation in the mtDNA ND2 gene and intron 9 of the Z-linked aconitase gene (ACO1I9) across the Common Chiffchaff range, including a recently discovered population breeding on Mt. Hermon (Anti-Lebanon mountains). Our data supported the monophyly of the chiffchaff complex and its current systematics at the species level. Within the Common Chiffchaff, the Siberian race P. c. tristis was the most differentiated subspecies and may represent a separate or incipient species. Other Common Chiffchaff subspecies also were differentiated in their mtDNA, however, lineages of neighboring subspecies formed wide zones of introgression. The Mt. Hermon population was of mixed genetic origin but contained some birds with novel unique lineage that could not be assigned to known subspecies. All Common Chiffchaff lineages diverged at the end of the Ionian stage of Pleistocene. Lineage sorting of ACO1I9 alleles was not as complete as that of mtDNA. Chiffchaff species were mostly distinct at ACO1I9, except the Common and Canary Islands Chiffchaffs that shared multiple alleles. An AMOVA identified geographic structure in Common Chiffchaff ACO1I9 variation that was broadly consistent with that of mtDNA ND2 gene. The genetic and other data suggest the chiffchaff complex to be a group of evolutionarily young taxa that represent a paradigm of 'species evolution in action' from intergrading subspecies through to apparently complete biological speciation.
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Aconitato Hidratasa/genética , ADN Mitocondrial/genética , Evolución Molecular , Variación Genética , NADH Deshidrogenasa/genética , Passeriformes/genética , Animales , Haplotipos , FilogeografíaRESUMEN
Hewitt's paradigm for effects of Pleistocene glaciations on European populations assumes their isolation in peninsular refugia during glacial maxima, followed by re-colonization of broader Europe during interstadials. This paradigm is well supported by studies of poorly dispersing taxa, but highly dispersive birds have not been included. To test this paradigm, we use the dunnock (Prunella modularis), a Western Palaearctic endemic whose range includes all major European refugia. MtDNA gene tree, multilocus species tree and species delimitation analyses indicate the presence of three distinct lineages: one in the Iberian refugium, one in the Caucasus refugium, and one comprising the Italian and Balkan refugia and broader Europe. Our gene flow analysis suggests isolation of both the Iberian and Caucasus lineages but extensive exchange between Italy, the Balkans and broader Europe. Demographic stability could not be rejected for any refugial population, except the very recent expansion in the Caucasus. By contrast, northern European populations may have experienced two expansion periods. Iberia and Caucasus had much smaller historical populations than other populations. Although our results support the paradigm, in general, they also suggest that in highly dispersive taxa, isolation of neighbouring refugia was incomplete, resulting in large super-refugial populations.
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Distribución Animal , Variación Genética , Refugio de Fauna , Pájaros Cantores/fisiología , Animales , Europa (Continente) , Haplotipos , Filogenia , Filogeografía , Análisis de Secuencia de ADN , Pájaros Cantores/genéticaRESUMEN
BACKGROUND: Acute basilar artery occlusion (BAO) is considered among the most severe medical emergencies, with very high morbidity and mortality. The aims of this study are to present 5 years experience of 12 centers in Lombardy region on BAO endovascular treatment and to evaluate prognostic factors that may improve clinical outcomes and recanalization rates. MATERIALS AND METHODS: Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) registry is a retrospective multicentric collection of patients with acute BAO who underwent endovascular treatment between 2010 and 2015. A total of 102 patients (mean age 65 years) were included. Clinical, procedural, and neuroradiological data were collected. Angiographic results (Treatment in Cerebral Ischemia scale [TICI] score 2b-3) were assessed by each center's interventional neuroradiologist. Good clinical outcome was considered as a modified Rankin Scale score ranging between 0 and 2 in a 3-month follow-up. RESULTS: Thirty-nine percent of patients showed good clinical outcome at 3 months. Mortality rate was 30%. TICI 2b-3 was achieved in 62% of patients. Univariate analysis showed that age, National Institutes of Health Stroke Scale (NIHSS) at onset, time to recanalization, and TICI score were all statistically significant clinical outcome predictors (P < .05). Multivariate logistic regression showed that time to recanalization, age, and NIHSS at onset were significant independent predictors of good outcome. CONCLUSIONS: BAO treatment needs more efforts to assure patients better clinical outcomes. Mechanical thrombectomy is feasible and effective in patients with acute BAO. These results must be confirmed by further prospective studies within randomized controlled settings.
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Procedimientos Endovasculares , Trombectomía , Insuficiencia Vertebrobasilar/terapia , Enfermedad Aguda , Anciano , Angiografía Cerebral , Distribución de Chi-Cuadrado , Evaluación de la Discapacidad , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/métodos , Procedimientos Endovasculares/mortalidad , Femenino , Humanos , Italia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Recuperación de la Función , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Trombectomía/efectos adversos , Trombectomía/métodos , Trombectomía/mortalidad , Factores de Tiempo , Resultado del Tratamiento , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Insuficiencia Vertebrobasilar/mortalidad , Insuficiencia Vertebrobasilar/fisiopatologíaRESUMEN
New skeletal elements of the recently described endemic giant anseriform Garganornis ballmanni Meijer, 2014 are presented, coming from the type-area of the Gargano and from Scontrone, southern and central Italy, respectively. The new remains represent the first bird remains found at Scontrone so far, and another shared element between these two localities, both part of the Apulia-Abruzzi Palaeobioprovince. The presence of a very reduced carpometacarpus confirms its flightlessness, only previously supposed on the basis of the very large size, while the morphologies of tarsometatarsus and posterior phalanges clearly indicate the adaptation of G. ballmanni to a terrestrial, non-aquatic, lifestyle. Its very large body size is similar to that observed in different, heavily modified, insular waterfowl and has been normally interpreted as the response to the absence of terrestrial predators and a protection from the aerial ones. The presence of a carpal knob in the proximal carpometacarpus also indicates a fighting behaviour for this large terrestrial bird species.
RESUMEN
We report the occurrence of the recently-described Stiphrornis pyrrholaemus in the Makokou area, northeastern Gabon, more than 600 kilometers NE from its type locality, in areas covered by dense primary to secondary forest. The previous records of Stiphrornis from the same area were referred to S. xanthogaster. We confirm this attribution on the basis of museum specimens. Although several recent sources treat all Stiphrornis as a single species, our findings strongly suggest the sympatric coexistence of two Stiphrornis species and thus that they should be treated as separate species under the Biological Species Concept.
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Passeriformes/clasificación , Simpatría , Distribución Animal , Estructuras Animales/anatomía & histología , Estructuras Animales/crecimiento & desarrollo , Animales , Tamaño Corporal , Ecosistema , Femenino , Gabón , Masculino , Tamaño de los Órganos , Passeriformes/anatomía & histología , Passeriformes/genética , Passeriformes/crecimiento & desarrolloRESUMEN
Diagnosis of Creutzfeldt-Jakob disease during life can be challenging since the huge variability of the symptoms which can be observed, especially in its early stages, may simulate other common forms of dementia. In latest years, noninvasive techniques such as magnetic resonance, positron emission tomography, and single-photon emission tomography have been evaluated to help clinical neurologists to provide a definite diagnosis. We here provide a systematic review of the current knowledge of neuroimaging in CJD in order to establish the actual state of the art.
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Encéfalo/diagnóstico por imagen , Encéfalo/patología , Síndrome de Creutzfeldt-Jakob/diagnóstico , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada de Emisión/métodos , Medicina Basada en la Evidencia , Humanos , Neuroimagen/métodos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
The past geographic distribution of the genus Theropithecus (Primates: Cercopithecidae) is mainly restricted to Africa. Outside that continent, the earliest reported records of this genus consist of a calcaneus of cf. Theropithecus sp. from 'Ubeidiya (Israel, 1.6-1.2 Ma [millions of years ago]), as well as three associated cervical vertebrae from Pirro Nord (Italy, 1.7-1.3 Ma) attributed to Theropithecus sp. The attribution of the Pirro Nord vertebrae to this genus has been disputed on morphometric grounds, although their assignment to a large-bodied cercopithecid has remained undisputed. Here we report unpublished cervical vertebral specimens with a similar morphology and, given their significance for the paleobiogeography of Theropithecus (purportedly representing its earliest European record), we re-evaluate their taxonomic attribution. In particular, we reconsider the possibility that they belong to another non-primate mammal recorded at this site. Based on both qualitative and metric morphological comparisons, we strongly favor an alternative attribution of the cervical vertebrae from Pirro Nord to the large porcupine Hystrix refossa, which is widely documented at the site by both dentognathic and other postcranial remains. We therefore conclude that the dispersal of Theropithecus out of Africa before ca. 1 Ma (when it is recorded by dental remains from Cueva Victoria, Spain) is currently based only on the calcaneus from 'Ubeidiya tentatively attributed to this genus.
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Vértebras Cervicales/anatomía & histología , Fósiles , Puercoespines/anatomía & histología , Theropithecus/anatomía & histología , Animales , ItaliaRESUMEN
Cercopithecid fossil remains from the post-evaporitic Messinian (5.40-5.33 Ma, MN13, latest Turolian, latest Miocene) locality of Moncucco Torinese (Tertiary Piedmont Basin, NW Italy) are described. A talus is assigned to the fossil colobine Mesopithecus pentelicus, while a proximal fragment of ulna and a male lower canine are attributed to cf. Me. pentelicus. An isolated I(2) and M3 are assigned to the papionin cf. Macaca sp., and two cercopithecid phalanges are left unassigned even to the subfamily level. The record of Mesopithecus at Moncucco Torinese agrees well with the previously-known range of this species in Italy and elsewhere in Europe, whereas that of cf. Macaca constitutes only the second occurrence of macaques in the Miocene of Eurasia. Although the co-occurrence of these two genera in a single locality had been previously reported in the Pliocene, this is the first instance in which macaques are associated with the Late Miocene M. pentelicus instead of Mesopithecus monspessulanus. The record of cf. Macaca and Mesopithecus-and especially the latter's talar morphology, similar to that of extant arboreal colobines-fits well with paleoenvironmental reconstructions of Moncucco Torinese based on the associated fauna, which indicate a humid and densely-forested environment, probably with more open and drier habitats nearby. From a paleobiogeographic viewpoint, the record of Macaca at Moncucco Torinese, together with the previously reported occurrence at Almenara-Casablanca M (Spain), supports the contention that macaques dispersed from Africa into Europe during the latest Miocene (ca. 5.9-5.3 Ma) at the same time as the sea level drop associated with the Messinian Salinity Crisis.
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Colobinae/anatomía & histología , Astrágalo/anatomía & histología , Animales , Antropología Física , FósilesRESUMEN
Some flint lithic artifacts were discovered in the fissure fillings of the well-known Pirro Nord site (Apulia, Southern Italy). The lithic industry, composed by three cores and some flakes, has been found to be associated to an Early Pleistocene vertebrate fossil assemblage. The fossil association contains a wide range of micromammals, including Allophaiomys ruffoi and Episoriculus gibberodon and large mammals including Bison degiulii and Equus altidens together with African elements as the gelada baboon Theropithecus and the saber-toothed cat Megantereon whitei. It defines the latest Villafranchian chronological unit (Pirro Nord Faunal Unit) in the Western European mammal biochronology. The lithic industry of Pirro Nord represents the oldest occurrence of the genus Homo in Europe as it is attributable to a chronological interval between 1.3 and 1.7 Ma. This supports the hypothesis that the genus Homo, with Oldowaian technology, extended its range in Europe, probably from western Asia, during the first half of the Early Pleistocene. The new discovery from Pirro Nord changes the chronology of the first arrival of hominids in Europe and offers new perspectives in the debate about the human dispersal in the Early Pleistocene.
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Fósiles , Hominidae , Animales , Huesos/anatomía & histología , Europa (Continente) , Humanos , Italia , Columna Vertebral/anatomía & histología , TheropithecusRESUMEN
The pathogenesis of cervical artery dissection is poorly understood. Deficiency of the elastase inhibitor alpha-1-antitrypsin may represent a predisposing condition. Biochemical and genetic analyses in a series of 12 consecutive patients with spontaneous dissection of the neck vessels showed 3 cases associated to alpha-1-antitrypsin deficiency, in combination with transient precipitating factors. A disequilibrium between proteolytic enzymes and protease inhibitors may contribute to the pathogenesis of cervical artery dissection leading to structural abnormalities of the extracellular matrix and increasing the susceptibility of the vessel wall to additional short-lived trigger mechanisms.