Coarctation of the thoracic aorta associated with cerebral arterial occlusive disease.

Since coarctation of the aorta was first described by Johann Friederich Meckel in 1760 [1], a vast literature has appeared on its associated conditions and treatment. This anomaly of the descending thoracic aorta is usually located distal to the left subclavian artery and is commonly found in coexistence with intraand extracardiac pathology. Ventricular and / or atrial septal defects [2], as well as discrete subvalvular stenosis, represent the accompanying intracardiac conditions [3, 4]. The presence of a bicuspid aortic valve was first noted by Edwards [5] and is found in 85% of patients afflicted by coarctation of the aorta [6]. Supravalvular stenosis is only rarely an associated anomaly [7], whereas the presence of patent ductus arteriosus is rather common [8]. Dilatation of the ascending aorta and aneurysms of the sinus of Valsalva combined with coarctation have also been reported [9]. Whenever the patient does not suffer from Turner syndrome [10], anomalies involving organs other than the heart and the thoracic aorta are rarely seen in coarctation . However, aneurysms of the circle of Willis were noted by Hodes et al. [11] and are the cause of cerebral hemorrhage, which is a major complication in the natural history of coarctation . Coarctation of the aorta in association with cerebral arterial occlusive disease, to our knowledge, has not been reported previously. We report two patients with such a combination . The question to be considered is whether this represents a fortuitous association or whether both entities have a common etiology.