Contribution of intracranial vertebral artery asymmetry to vestibular neuropathy

Abstract

VAH may serve as a regional haemodynamic negative contributor and impede blood supply to the ipsilateral vestibular labyrinth, contributing to the development of VN, which could be enhanced by atherosclerotic risk factors and the left-sided location.

Intracranial region of the vertebral artery: morphometric study in the context of clinical usefulness

“…Hypoplasia of V 4 remains an uncommon embryogenic variation of the posterior circulation, which could have important haemodynamic implications (hypoperfusion and insufficient circulation) in acute brainstem/cerebellar ischaemic stroke [17,19], or in the lateralisation of vestibular neuropathy [8]. In the pathoanatomical studies, hypoplastic VA is defined as a lumen diameter of < 3, < 2.5, < 2.2 or < 2 mm, and there is no consensus on this value [7,19].…”

Vertebral Artery Diameter and Flow: Nature or Nurture

“…Furthermore, VAH served as an independent factor for a reduction of posterior circulation blood flow velocity and may contribute to vertebro‐basilar ischemic events particularly in the territory of the posterior inferior cerebellar artery (PICA) since it limits the potential of compensatory flow in case of major intracranial occlusion . In general, VAH has been related to several diseases: symptomatic or asymptomatic pontine infarctions were reported to be more common, basilar artery occlusions were found to be more frequent in VAH than in cases with nonbrainstem infarctions, and migraine with aura and vestibular neuronitis . The episodic dizziness with sensori‐neural hearing impairment associated with recurrent hemodynamic decrease of the Intracranial Vertebral‐Basilar Artery Hypoplasia was also associated with VAH …”

“…1 In general, VAH has been related to several diseases: 1 symptomatic or asymptomatic pontine infarctions were reported to be more common, 7 basilar artery occlusions were found to be more frequent in VAH than in cases with nonbrainstem infarctions, 8 and migraine with aura and vestibular neuronitis. 9,10 The episodic dizziness with sensori-neural hearing impairment associated with recurrent hemodynamic decrease of the Intracranial Vertebral-Basilar Artery Hypoplasia was also associated with VAH. 11 Since VAH is not a rare finding and it might be clinically relevant, we were interested to investigate whether the variation in VA diameter and flow is genetically influenced.…”

Vertebral artery hypoplasia and vertebral artery dissection

“…3 No standard definition of this condition according to vessel diameter has been established, 3,4 but operational definitions have been based on diameters of ,2 to ,3 mm or caliber discrepancy $1:1.7. 8,9 Moreover, emerging evidence from case reports has suggested that VAH is a predisposing factor for spontaneous VA dissection (sVAD). 4 VAH has been insufficiently studied, but in the past years, VAH has been given increasing attention because of accumulating evidence suggesting it is not a benign vessel variant, as previously believed.…”