Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts

Hong, J. M.; Chung, C.-S.; Bang, O. Y.; Yong, S. W.; Joo, I. S.; Huh, K.
October 2009
Journal of Neurology, Neurosurgery & Psychiatry;Oct2009, Vol. 80 Issue 10, p13
Academic Journal
Objectives: The diameters of the vertebral arteries (VAs) are very often unequal. Therefore, this study investigated if unequal VA flow contributes to the development of basilar artery (BA) curvature and if it is a link to the laterality of pontine or cerebellar infarcts occurring around the vertebrobasilar junction. Methods: Radiological factors were analysed (infarct laterality, VA dominance, BA curvature and their directional relationships) in 91 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarcts. The "dominant" VA side was defined as either that the VA was larger in diameter or the VA was connected with the BA in more of a straight line, if both VAs looked similar in diameter on CT angiography. Multiple regression analysis was performed to predict moderate to severe BA curvature. Results: The dominant VA was more frequent on the left side (p<0.01). Most patients had an opposite directional relationship between the dominant VA and BA curvature (p<0.01). Pontine infarcts were opposite to the side of BA curvature (p<0.01) and PICA infarcts were on the same side as the non-dominant VA side (p<0.01). The difference in VA diameters was the single independent predictor for moderate to severe BA curvature (OR per 1 mm, 2.70; 95% CI 1.22 to 5.98). Conclusions: Unequal VA flow is an important haemodynamic contributor of BA curvature and development of peri-vertebrobasilar junctional infarcts.


Related Articles

  • Do patients with basilar or vertebral artery stenosis have a higher stroke incidence poststenting? Jiang, W-J; Du, B.; Hon, S. F. K.; Jin, M.; Xu, X-T; Ma, N.; Gao, F.; Dong, K-H // Journal of NeuroInterventional Surgery;Mar2010, Vol. 2 Issue 1, p50 

    The article reports on a study that tested the hypothesis that there is no difference in clinical outcome poststenting between patients with severe stenosis of the basilar artery (BA) and intercranial vertebral artery (VA). The results indicate a higher stroke risk poststenting in patients with...

  • Validity of Continuous-Wave Doppler Sonography of the Vertebrobasilar System. Karnik, Ronald; Stöllberger, Claudia; Ammerer, Hans-Peter; Perneczky, Gedeon; Slany, Jörg; Brenner, Heinz // Angiology;Jul1987, Vol. 38 Issue 7, p556 

    To assess the value of continuous-wave Doppler sonography for detection and exclusion of lesions in the vertebrobasilar system, the ultrasonic and angiographic findings were compared in a prospective study. Altogether, 200 vertebral arteries in 176 patients were evaluated by both methods....

  • Duplication of the Left Vertebral Artery Origin: A Case Report. Sang-Wook Shin; Dong Woo Park; Choong Ki Park; Young Jun Lee; Seung Ro Lee // Journal of the Korean Society of Radiology;Jan2013, Vol. 68 Issue 1, p1 

    Duplication of vertebral arteries is a very rare but clinically important condition. A duplicated vertebral artery origin can influence hemodynamics, pathogenesis of vascular lesions and treatment options. In cases of vertebral artery duplication, the vertebral arteries generally enter the...

  • Dissecting aneurysms of the vertebrobasilar system. A comprehensive review on natural history and treatment options. Santos-Franco, Jorge Arturo; Zenteno, Marco; Lee, Angel // Neurosurgical Review;Apr2008, Vol. 31 Issue 2, p131 

    Vertebral artery dissection has been recognized as an uncommon cause of ischemic stroke. However, it is less well known as a cause of subarachnoid hemorrhage. Even if dissecting aneurysms of the vertebral artery are rare, their importance arise from their high morbidity and mortality with...


    Nine patients with signs and symptoms of vertebral-basilar artery insufficiency and with the diagnosis of multiple sclerosis experienced partial restoration of lost neurologic function with the revascularization of ischemic tissue of the hindbrain by an operation to correct partial extraluminal...

  • Abstracts. Pavone, Eugene // Physical Therapy;Nov1995, Vol. 75 Issue 11, p1030 

    Presents an abstract of the report `The Premanipulative Vertebral Artery Testing Protocol: A Brief Review,' by D.A. Rivett, published in `The New Zealand Journal of Physiotherapy.'

  • Stent Placement to Treat Ruptured Vertebral Dissecting Aneurysms. YONG-AN CHEN; RONG-BO QU; YU-SONG BIAN; WEI ZHU; KUN-PENG ZHANG; QI PANG // Interventional Neuroradiology;Dec2013, Vol. 19 Issue 4, p479 

    Conventional endovascular treatment may have limitations for vertebral dissecting aneurysm involving the origin of the posterior inferior cerebellar artery (PICA). We report our experiences of treating vertebral dissecting aneurysm with PICA origin involvement by placing a stent from the distal...

  • Rare saccular aneurysm in a medial type persistent trigeminal artery trunk and literature review. Bai, Min; Guo, Qian; Sun, Yunxia // Surgical & Radiologic Anatomy;Apr2014, Vol. 36 Issue 3, p299 

    Purpose: We report an extremely rare case of saccular aneurysm in the left medial type persistent trigeminal artery (PTA) trunk and discuss its clinical importance. Materials and methods: A 77-year-old woman who had symptom suggestive of vertebrobasilar insufficiency underwent cerebral magnetic...

  • Vertebrobasilar disease may be a challenge to pinpoint. Charters, Lynda // Ophthalmology Times;5/1/2005, Vol. 30 Issue 9, p44 

    The article presents information about vertebrobasilar disease. Early diagnosis of the disease is important, but the diagnosis can be difficult unless ophthalmologists know the anatomy involved and the symptoms to look for. Mark Moster, MD, outlined the important points for ophtbalmologists who...


Read the Article


Sign out of this library

Other Topics