TITLE

Vertebrobasilar dolichoectasia diagnosed by magnetic resonance angiography and risk of stroke and death: a cohort study

AUTHOR(S)
Ubogu E E; Zaidat O O
PUB. DATE
January 2004
SOURCE
Journal of Neurology, Neurosurgery & Psychiatry;Jan2004, Vol. 75 Issue 1, p22
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: There are only limited epidemiological studies evaluating the association between vertebrobasilar dolichoectasia (VBD) and outcomes. This study was designed to elucidate the outcome and prognosis of adults diagnosed with VBD by magnetic resonance angiography (MRA) and to ascertain if these outcomes were independent of known vascular risk factors. METHODS: A cohort study was designed to compare VBD cases identified retrospectively from a computerised database of MRA reports with age and sex matched controls evaluated after a 4-7 year period, and 1440 MRA reports were reviewed. The inclusion criteria were age > or =18 years and a radiological diagnosis of VBD. Patients were excluded if there was haemodynamically significant stenosis or occlusion of the posterior circulation. Data were obtained by medical record review and telephone questionnaires. The primary outcome measure was transient or fixed posterior circulation dysfunction (PCD), with a secondary outcome measure of all cause mortality. RESULTS: Sixty four VBD cases were obtained, and 19 cases (30%) were excluded due to refusal and/or insufficient follow up data. From the same computerised database, 45 controls were selected by consecutive sampling. The mean age at follow up was 73.4 years for VBD cases and 73.1 years for controls, with a median follow up period of 64 months. VBD was associated with fixed/transient PCD (p = 0.0001; estimated adjusted odds ratio (OR) of 20.6 and confidence interval (CI) of 4.4 to 95.3), and with all cause mortality (OR = 3.6 CI 1.3 to 10.3); (p = 0.018). VBD cases had 36% mortality, with 50% occurring within 34 months of the initial diagnosis. The VBD cumulative survival curve was statistically different from the controls (p = 0.012 by Mantel-Cox log rank test). CONCLUSIONS: This study suggests that VBD may be an independent risk factor for stroke. VBD cases had an increased likelihood for PCD, all cause mortality, and reduced cumulative survival independent of other vascular risk factors in this cohort. Larger population based prospective studies are required to verify these results.
ACCESSION #
12136911

 

Related Articles

  • Low Detection Rate of Craniocervical Arterial Dissection in Children Using Time-of-Flight Magnetic Resonance Angiography: Causes and Strategies to Improve Diagnosis. Tan, Marilyn A.; deVeber, Gabrielle; Kirton, Adam; Vidarsson, Logi; MacGregor, Daune; Shroff, Manohar // Journal of Child Neurology;Oct2009, Vol. 24 Issue 10, p1250 

    Craniocervical arterial dissection is a frequent cause of childhood arterial ischemic stroke requiring prompt diagnosis and treatment. However, there is no universal guideline for diagnostic cerebrovascular imaging in children. We assessed the role of time-of-flight magnetic resonance...

  • Distribution territories and causative mechanisms of ischemic stroke. Rovira, A.; Grivé, E.; Alvarez-Sabin, J.; Grivé, E // European Radiology;Mar2005, Vol. 15 Issue 3, p416 

    Ischemic stroke prognosis, risk of recurrence, clinical assessment, and treatment decisions are influenced by stroke subtype (anatomic distribution and causative mechanism of infarction). Stroke subtype diagnosis is better achieved in the early phase of acute ischemia with the use of multimodal...

  • Comparison of increased venous contrast in ischemic stroke using phase-sensitive MR imaging with perfusion changes on flow-sensitive alternating inversion recovery at 3 Tesla. Yamashita, Eijiro; Kanasaki, Yoshiko; Fujii, Shinya; Tanaka, Takuro; Hirata2, Yoshiharu; and Toshihide Ogawa1 // Acta Radiologica;Oct2011, Vol. 52 Issue 8, p905 

    Background: Increased venous contrast in ischemic stroke using susceptibility-weighted imaging has been widely reported, although few reports have compared increased venous contrast areas with perfusion change areas. Purpose: To compare venous contrast on phase-sensitive MR images (PSI) with...

  • Literature Review: IMAGING.  // Current Medical Literature: Stroke Review;2004, Vol. 8 Issue 1, p21 

    Presents a review of literature on stroke and medical imaging. "Beyond mismatch: evolving paradigms in imaging the ischemic penumbra with multimodal magnetic resonance imaging," by C. S. Kidwell et al; "Validation of computed tomographic middle cerebral artery "dot" sign: an angiographic...

  • Multimodal MR examination in acute ischemic stroke. Mezzapesa, D. M.; Petruzzellis, M.; Lucivero, V.; Prontera, M.; Tinelli, A.; Sancilio, M.; Carella, A.; Federico, F. // Neuroradiology;Apr2006, Vol. 48 Issue 4, p238 

    In recent years, combined diffusion-weighted imaging (DWI) with perfusion imaging (PI) has become an important investigational tool in the acute phase of ischemic stroke, as it may differentiate reversible from irreversible brain tissue damage. We consecutively examined 20 subjects within 12 h...

  • MR Angiography Compared to Conventional Selective Angiography in Acute Stroke. Tomanek, Anna I.; Coutts, Shelagh B.; Demchuk, Andrew M.; Hudon, Mark E.; Morrish, William F.; Sevick, Robert J.; Simon, Jessica E.; Frayne, Richard; Buchan, Alastair M.; Hill, Michael D. // Canadian Journal of Neurological Sciences;Feb2006, Vol. 33 Issue 1, p58 

    The article presents a study of the accuracy of magnetic resonance angiography (MRA) in evaluating intracranial vessels in acute stroke compared to conventional selective angiography. Study subjects were 29 patients with acute stroke or transient ischemic attack. Results showed that MRA is a...

  • Imaging of acute stroke. Choksi, Vaishali; Quint, Douglas J.; Maly-Sundgren, Pia; Hoeffner, Ellen // Applied Radiology;Feb2005, Vol. 34 Issue 2, p10 

    Discusses the use of imaging in patients with acute onset of stroke-like symptoms. Use of computed tomography for initial evaluation of patients with suspected stroke; Information on conventional magnetic resonance imaging (MRI); Basis of the diffusion-weighted MRI; Details of CT angiography.

  • INCOMPETENT CIRCLE OF WILLIS AND VERTEBROBASILAR INSUFFICIENCY. Welsh, Louis W.; Lewin, Bernard; Welsh, John J.; Dragonette, Joseph E. // Annals of Otology, Rhinology & Laryngology;Aug2003, Vol. 112 Issue 8, p657 

    Analyzes the vascular basis of vertebrobasilar insufficiency by examination of 135 subjects by magnetic resonance imaging and angiography. Difference between potential for intracerebral collaterization and regional perfusion due to structural defects such as stenosis; Normal configurations,...

  • QUESTION 2 Neurological complications of diagnostic cerebral catheter angiography in children. McCrea, Nadine; Robertson, Fergus; Ganesan, Vijeya // Archives of Disease in Childhood;May2014, Vol. 99 Issue 5, p483 

    In this article, the author focuses on possibility of neurological complications due to diagnostic catheter cerebral angiography (CA) in children. The author mentions that despite of non-invasive cerebrovascular imaging techniques like Magnetic resonance angiography (MRA) but CA remains the...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics