AHA/ASA volunteer expert Philip B. Gorelick, M.D., offers perspective (via Skype) on ISC 19 abstract 189 and abstract WMP49. He is professor, Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, Mercy Health Hauenstein Neurosciences, Grand Rapids, Michigan. copyright American Heart Association "So what is the mechanism here? That is something that's really important to understand. Let's focus on the cervical neck dissections and I think the likely cause would be inflammation, because the fluids associated with inflammation as an inflammatory disease. By definition it's usually a viral illness and so the question comes, what is the specific mechanism of inflammation, is the underlying or over reaching mechanism. I don't think we know that for sure. Is it possible that a virus or viral particle got into the artery wall? Yes, that is certainly possible. Is it possible that there has been inflammatory storm, meaning inflammatory mediators have been hyped up because of the viral illness? Yes, that's certainly possible. Or could both things occur? I don't think we know the answer to that, but again, the umbrella here, or the over arching issue I think has to do with inflammation."