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.
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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 11/1986; 17(6):1277-81. DOI:10.1161/01.STR.17.6.1277 · 6.02 Impact Factor
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ABSTRACT: We describe a patient with an ecstatic basilar artery in whom MRI showed marked indentation of the floor of the third ventricle and backward displacement of the midbrain, probably causing aqueduct stenosis. It appeared likely that the associated hydrocephalus was due not only to any "water-hammer" effect, but also to occlusion of the aqueduct.Neuroradiology 02/1993; 35(6):447-8. DOI:10.1007/BF00602826 · 2.37 Impact Factor
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ABSTRACT: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disorder with a variety of cardiovascular manifestations. This study presents a group of patients with ADPKD who had intracranial arterial dolichoectasia. One hundred seventy-eight ADPKD patients were screened with magnetic resonance angiography, 40 ADPKD patients had conventional angiography, and 98 ADPKD patients underwent a brain autopsy. For comparison, 360 patients without ADPKD who had magnetic resonance angiography and conventional angiography or brain autopsy were also studied. The prevalence of asymptomatic intracranial arterial dolichoectasia was 2.2% (4 of 178), 2.5% (1 of 40), and 2.0% (2 of 98) in the three ADPKD groups, respectively. None of the patients without ADPKD had intracranial arterial dolichoectasia. In addition to the seven patients with asymptomatic disease, two ADPKD patients with vertebrobasilar dolichoectasia had posterior circulation ischemic symptoms. The mean age of the nine patients (five men and four women) was 56.6 yr (range, 41 to 67 yr). The posterior circulation was involved in five patients, the anterior circulation was involved in two patients, and both were involved in two patients. Arterial dissection was believed to have caused middle cerebral artery dolichoectasia in one patient, and intracranial arterial dissections were strongly suspected in two other patients. Six of the nine patients with intracranial arterial dolichoectasia had additional vascular manifestations of ADPKD. Some patients with ADPKD are at an increased risk of developing intracranial arterial dolichoectasia and dissections. Recognizing this association is important because (1) it may be a cause of stroke; (2) it may mimic a saccular aneurysm on radiographic studies; and (3) it suggests that the arteriopathy of ADPKD may be more generalized than previously believed.Journal of the American Society of Nephrology 09/1997; 8(8):1298-303. · 9.47 Impact Factor