The Relationship Between Vertebral Artery Hypoplasia and Posterior Circulation Stroke

Erdal, Yuksel; Bayramoğlu, Banu; Şişman, Çağla; Demiral, Ahmet Batuhan; Mahmutoğlu, Abdullah Soydan; Emre, Ufuk

doi:10.4274/imj.galenos.2022.75244

Cited by 1 publication

(3 citation statements)

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“…There were also no differences when the demographics were compared with non-VAH cases. 3 The general demographic profile of stroke in Indonesia had been reported by Stevano et al (2023), which was male (60.8%) of 60.55±13.54 years old with hypertension (77.8%), diabetes (36.6%), dyslipidemia (31.4%), previous stroke history (28.1%), obesity (19.6%), coronary heart disease (17.0%), etc. 9 The difference of demographic profile in this study and those in Turkey as well as the similarity of those in this study with another study in Indonesia may be explained by the difference in the prevalence of risk factors of stroke across countries.…”

Section: Discussionmentioning

confidence: 85%

“…It can be concluded that cerebral artery hypoplasia may be considered as an additional risk factor to the conventional vascular risk factors for subtle brain ischemia, symptomatic complaints, and recurrent stroke. 3,4,12 Cerebral artery hypoplasia was hypothesized either independently or in association with cardiovascular risk factors to produce clinical symptoms. Decreased vessel lumen may independently produce regional hypoperfusion.…”

Section: Discussionmentioning

confidence: 99%

“…While VAH was firstly considered as a non-dangerous anatomic variant, recent studies have associated its presence with increased predisposition for posterior circulation stroke, especially involving the posterior inferior cerebellar artery and lateral medullary infarcts, and when accompanied with other atherosclerotic risk factors. [2][3][4] Unilateral VAH may be associated with ipsilateral atherosclerosis of VA, relative hypoperfusion in ipsilateral PICA, and increased risk of contralateral cardioemboli whereas bilateral VAH may present with the involvement of multiple bilateral vascular teritories. 4 The most common types of anatomical variation in the circle of Willis includes hypoplasia of one or both of posterior communicating arteries (34-68%), hypoplasia of A1 segment of anterior cerebral artery (4-10%), absence of anterior communicating artery (12-21%), persistent fetal origin of posterior cerebral artery (4-26%), and infundibular dilatation of posterior communicating artery (7-15%).…”

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The prevalence, clinical characteristics, and brain MRI changes in intracranial artery hypoplasia: a retrospective single-center cross-sectional study

Usman,

Pariama,

Aiko

et al. 2023

Int J Res Med Sci

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reduced cerebral blood flow, increased atherosclerosis, and aneurysm formation. This study aimed to describe the profile of vertebral artery hypoplasia (VAH), anterior CAH (ACAH), and posterior CAH (PCAH) in symptomatic subjects. Methods: This was a retrospective cross-sectional study using medical record in a secondary private hospital in Jakarta, Indonesia, in January-December 2022. The inclusion criteria were age ≥18 years with neurological symptoms, underwent brain MRI, and being diagnosed with CAH using DSA. The exclusion criteria were findings of other vascular pathologies including dissection and >50% intracranial vessel stenosis. Demographics of age, sex, body mass index (BMI), hypertension, diabetes, cardiac disorder, and previous stroke were analyzed among VAH, PCAH, and ACAH groups. Results: Of 769 subjects with clinical symptoms undergoing DSA, there were 66 (8.6%) cases of intracranial artery hypoplasia, including VAH (4.6%), PCAH (1.2%), and ACAH (2.9%). Subjects were predominantly old (53.2±10.1 years), male (53.0%), with BMI of 24.9±3.9 kg/m2 and hypertension (69.7%). Previous stroke (69.7%) was more prevalent than in previous study (28.1%). Stroke and brain ischemic lesion were detected in 89.4% and 84.8% cases. No differences were found in all parameters among all groups, but posterior circulation symptoms tended to be found in VAH (28.1%) than general stroke (20.3%). Conclusions: The high percentage of recurrent stroke and corresponding clinical symptoms associated with CAH supported that CAH may be a risk factor for clinical symptoms, including stroke, regardless of the involved artery.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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