MRI Findings in Megadolicho-Basilar Artery

Salbeck, R; Busse, O.; Reinbold, W. D.

doi:10.1159/000108721

Cited by 6 publications

(4 citation statements)

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“…This gives rise to the development of adjacent thrombi, which fail to organize but change their surface with simultaneous cross formation and thrombolysis [11]. Such thrombi may cause brain infarction by two different mechanisms; either 'directly' by occluding the origin of penetrating small vessels, or 'indirectly' by arterio-arterial embolization into distal vascular territories [12].…”

mentioning

confidence: 99%

Treatment Options in Vertebrobasilar Dolichoectasia – Case Report and Review of the Literature

Dziewas

Freund²,

Lüdemann³

et al. 2003

Eur Neurol

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mentioning

confidence: 99%

Treatment Options in Vertebrobasilar Dolichoectasia – Case Report and Review of the Literature

Dziewas

Freund²,

Lüdemann³

et al. 2003

Eur Neurol

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“…With respect to the postulated biological mechanism as proposed by Hegedues, Sahlbeck et al and Schwartz et al [6,[15][16][17][18][19][20], the increase in vessel diameter with dilatation, blood flow velocity is reduced and may show a plug of inversion or even zero flow near the vessel wall by transcranial Doppler evidence [6]. Ring shaped layering of thrombus formation occurs with a smaller patent lumen and thrombus may enter origin of small penetrating vessels of 200-800 micrometers and give rise to thrombotic occlusion and lacunar infarction in the setting of large vessel (dolichoectatic) rather than small vessel disease.…”

Section: Prognosis and Treatmentmentioning

confidence: 99%

Dolichoectasia - A Posterior Circulation, Large Vessel Vasculopathy with Unique Clinical and Radiologic Features

Hoffmann¹,

Brock²

2014

J Neurol Neurophysiol

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Aim:To determine the frequency and clinicoradiologic features of patients with dolichoectasia in large vessel ischemic cerebrovascular disease in a tertiary referral based stroke population. Methods:A standardized prospective investigative protocol including brain imaging, angiography and sonography was applied to all cerebrovascular patients (n=1292). Retrospective analysis was performed in patients with stroke or transient ischemic attack with radiological features of dolichoectasia. Comparison was made between large vessel atherosclerotic (LVA) vasculopathies (n=355) and large vessel dolichoectasia (LVDE). Results:Within the stroke registry, LVDE comprised of 50/1292 (3.9%) with strokes and 10/223 (4.5%) presented with TIA's (p=NS). Risk factor comparison between LVA and LVDE was not significant for gender, age, hypertension, hyperlipidemia, smoking, alcohol excess, ischemic heart disease and diabetes mellitus. Clinical stroke presentation differed significantly for total anterior circulation (TAC) (p=0.002) and partial anterior circulation (PAC) (p=-0.001) being more numerous in LVA. In the LVDE group posterior circulation (POC) ischemia was more numerous (p=<0.0001). Most frequent isolated symptoms in the LVDE group included vertigo (17/60; 28%), ataxia (13/60; 22%), facial weakness (12/60; 20%), diplopia (6/60; 10%). Quantitative neurological deficit by Canadian Neurological Scale (CNS) and disability (Rankin) did not differ significantly between LVDE and LVA. Angiographic abnormalities involved the basilar artery in 47/50 (94%) of the stroke subgroup and 9/10 (90%) of the TIA subgroup of the LVDE group. Posterior circulation lesions were seen in 33/50 (67%) of LVDE and 64/355 (18%) of LVA (p=0.0001). During a 7 year follow up period (mean 4.5 years), recurrent stroke or TIA occurred in 10/50 (20%) in the LVDE as opposed to 8/355 (2.3%) in the LVA group (p=<0.0001). No further sequele occurred in the LVDE group treated with anticoagulation (n=9/10) as opposed to antiplatelet therapy (1 died of myocardial infarct) in a 2.5 year follow up period.Conclusion: 1. LVDE differs significantly from LVA disease in terms of posterior circulation symptoms, stroke syndromes, brain parenchymal and angiographic features. 2. Recurrent stroke or TIA may be more frequent in LVDE and anticoagulation may be required more often in this subgroup. J o ur nal of N e u ro lo gy & N eu ro ph ysiolo g y ISSN: 2155-9562 Risk factors Citation: Hoffmann M, Brock C (2014) Dolichoectasia -A Posterior Circulation, Large Vessel Vasculopathy with Unique Clinical and Radiologic Features. DiscussionThis study represents one of the largest series to date of prospectively evaluated, retrospectively analyzed, dolichoectasia subtype cerebrovascular disease of the cerebral arteries, allowing delineation of the frequencies of different stroke syndromes associated Citation: Hoffmann M, Brock C (2014) Dolichoectasia -A Posterior Circulation, Large Vessel Vasculopathy with Unique Clinical and Radiologic Features.

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“…Die Thrombogenität des Blutes ist in den dilatierten Gefäßabschnitten aufgrund der dort pathologisch reduzierten Blutflussgeschwindigkeiten deutlich erhöht [8,19]. Die Patienten sind daher extrem gefährdet, einen Hirninfarkt durch eine simultane oder sequenzielle Okklusion mehrer Rami ad pontem oder eine arterioarterielle Embolie zu erleiden, und auch ihr Re-Insult-Risiko ist im Vergleich zu einer durchschnittlichen Population von Schlaganfallpatienten deutlich erhöht [6].…”

Section: Diskussionunclassified

Die dolichoectatische Basilaris

Dziewas¹,

Schilling²,

Fallenberg³

et al. 2003

Nervenarzt

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The megadolichobasilar artery is a rare vascular disease, which usually becomes apparent either due to cerebral ischemia or due to compression of the brainstem or the cranial nerves, thereby leading to a large variety of neurological symptoms. We report on a patient who suffered a sudden right-sided deafness accompanied by vertigo and vomiting. Initially, an idiopathic sensorineural hearing loss was diagnosed and later on, after no improvement took place in spite of conservative therapy, a rupture of the round window membrane was suspected. Two weeks after the first symptoms had occurred the patient developed a hemiparesis on the left side.Radiology disclosed a dilated and partially thrombosed basilar artery as well as a paramedian pontine infarction. We therefore assumed that the patient's symptoms had been caused by thrombotic occlusion of the labyrinthine artery and several rami ad pontem. The article reviews the great variety of clinical symptoms caused by megadolichobasilar artery and discusses important therapeutic options.

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MRI Findings in Megadolicho-Basilar Artery

Abstract: The authors describe the MRI findings in a case of megadolicho-basilar artery, seen over a period of 3 years. The value of MRI in monitoring the course of the megadolicho-basilar artery is discussed.

Cited by 6 publications

References 1 publication

Treatment Options in Vertebrobasilar Dolichoectasia – Case Report and Review of the Literature

Treatment Options in Vertebrobasilar Dolichoectasia – Case Report and Review of the Literature

Dolichoectasia - A Posterior Circulation, Large Vessel Vasculopathy with Unique Clinical and Radiologic Features

Die dolichoectatische Basilaris

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