Vertebral and/or basilar dolichoectasia in human adult cadavers.
ABSTRACT Intracranial arterial dolichoectasia is a condition in which arteries demonstrate an increase in length and diameter, with the vertebrobasilar system being the most commonly affected segment. Because the criteria for and degree of vertebrobasilar dolichoectasia are usually established on three-dimensional time-of-flight MR angiography, we presented the results of an anatomic study of vertebrobasilar dolichoectasia cadaveric specimens.
Examination was carried out on the brains of human adult cadavers, routinely dissected at the Institute of Forensic Medicine. Measurement of the outer diameter and length of vertebral and/or basilar arteries was performed using the ImageJ processing program.
There were 14 cases (14/216) of vertebral and/or basilar (dolicho)ectasia. Their classification into special (sub)types is made according to the basilar and/or vertebral diameter. The basilar length ranged from 32.91-59.37 mm, and the basilar outer diameter ranged from 3.51-8.92 mm in relation to the corresponding point of its measurement. The outer diameter of the vertebral arteries ranged from 0.67-5.91 mm. The Games-Howell post hoc test additionally showed that a basilar outer diameter of grade III and IV was significantly larger than in grade II (p < 0.05).
We noted a predisposition of males older than 40 years to arterial dolichoectasia in the vertebrobasilar system, independently from population group, as well as its asymptomatic appearance, independently from the presence of atherosclerotic plaques.
- SourceAvailable from: ncbi.nlm.nih.govJournal of Neurology Neurosurgery & Psychiatry 01/1995; 57(12):1544. · 4.92 Impact Factor
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ABSTRACT: The dolichoectatic basilar artery was found in 23 cases during a 10-year period. The 19 males and 4 females ranged in age from 30 to 69 years (mean: 55 years). Hypertension was noted in 17 patients. In seventeen (74%) of the present cases this anomaly could be visualized with CT scan. Seven patients (30%) presented with pontine infarction, which was identified on CT scan in all cases. Vertebro-basilar insufficiency was found in four patients. One patient had transient ischemic attacks. There were facial spasms in four patients and impairment of the lower cranial nerves in one. One patient exhibited cerebellar hemorrhage. In two patients this anomaly was found incidentally. Associated intracranial aneurysms were identified in seven patients, including fusiform aneurysms in 4 and saccular aneurysms in 3. Three patients had an accompanying hydrocephalus. The dolichoectatic basilar artery is associated with various consequences especially in relation to the pathogenesis of brainstem infarction. When this anomaly is diagnosed by CT findings, even if it is clinically asymptomatic, it may be better to treat these patients with medical therapy used to prevent ischemic stroke.Stroke 17(6):1277-81. · 6.16 Impact Factor
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ABSTRACT: The diameters of the vertebral arteries (VAs) are very often unequal. Therefore, this study investigated if unequal VA flow contributes to the development of basilar artery (BA) curvature and if it is a link to the laterality of pontine or cerebellar infarcts occurring around the vertebrobasilar junction. Radiological factors were analysed (infarct laterality, VA dominance, BA curvature and their directional relationships) in 91 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarcts. The "dominant" VA side was defined as either that the VA was larger in diameter or the VA was connected with the BA in more of a straight line, if both VAs looked similar in diameter on CT angiography. Multiple regression analysis was performed to predict moderate to severe BA curvature. The dominant VA was more frequent on the left side (p<0.01). Most patients had an opposite directional relationship between the dominant VA and BA curvature (p<0.01). Pontine infarcts were opposite to the side of BA curvature (p<0.01) and PICA infarcts were on the same side as the non-dominant VA side (p<0.01). The difference in VA diameters was the single independent predictor for moderate to severe BA curvature (OR per 1 mm, 2.70; 95% CI 1.22 to 5.98). Unequal VA flow is an important haemodynamic contributor of BA curvature and development of peri-vertebrobasilar junctional infarcts.Journal of neurology, neurosurgery, and psychiatry 05/2009; 80(10):1087-92. · 4.87 Impact Factor