Are we concerned enough about hyperhomocysteinemia

Stroke in young is on rise in every corner of the world and is presently a very serious concern. So, a modifiable etiology of stroke if found, needs to be addressed seriously. Hyperhomocysteinemia is a prominent risk factor for vascular event in young population. It is known to play an important role in coronary artery disease, peripheral vascular disease and stroke. Perhaps, it also has a significant role in arterial dissection, a prominent stroke etiology in young population. It is proposed that hyperhomocysteinemia and genetic polymorphism probably interact with environmental factors leading to sequence of pathogenetic events resulting in arterial wall dissection. The prevalence of vegetarian diet, genetic predisposition and diet pattern subject Indians to increased chance of hyperhomocysteinemia and vascular insult. Here, we present a very rare case of isolated spontaneous vertebral arterial dissection in a young gentleman who had no vascular risk factor except very high serum homocysteine level. Perhaps, this case highlights serious consideration for addressing this modifiable vascular risk factor as a possible association with arterial dissection to avoid catastrophic events, especially in this part of the world. Keywords: Hyperhomocysteinemia, Stroke, Arterial dissection.