Multimodality Imaging of Vertebrobasilar Dolichoectasia: Clinical Presentations and Imaging Spectrum
- 30 June 2016
- journal article
- research article
- Published by Radiological Society of North America (RSNA) in RadioGraphics
- Vol. 36 (4), 1129-1146
- https://doi.org/10.1148/rg.2016150032
Abstract
Vertebrobasilar dolichoectasia (VBD) is characterized by ectasia, elongation, and tortuosity of the vertebrobasilar arteries, with a high degree of variability in clinical presentation. The disease origin is believed to involve degeneration of the internal elastic lamina, thinning of the media secondary to reticular fiber deficiency, and smooth muscle atrophy. The prevalence of VBD is variable, ranging from 0.05% to 18%. Most patients with VBD are asymptomatic and their VBD is detected incidentally; however, it is important to recognize that the presence of symptoms, which can lead to clinically significant morbidity and sometimes mortality, may influence clinical management. The most important clinical presentations of VBD are vascular events, such as ischemic stroke and catastrophic intracranial hemorrhage, or progressive compressive symptoms related to compression of adjacent structures, including the cranial nerves, brainstem, or third ventricle, causing hydrocephalus. The imaging diagnostic criteria for computed tomography and magnetic resonance (MR) imaging include three quantitative measures of basilar artery morphology: laterality score, height of bifurcation, and basilar artery diameter. The authors review the relevant anatomy and disease origin of VBD; pertinent imaging findings, including intraluminal thrombus and relation to the cranial nerves; and imaging pitfalls, such as the hyperintense vessel sign on MR images and artifacts related to slow flow in the dolichoectatic vessel. In addition, clinical manifestations, the role of radiology in diagnosis and management of this condition, and available management options are reviewed. (C) RSNA, 2016.Keywords
This publication has 74 references indexed in Scilit:
- Visual Loss, Homonymous Hemianopia, and Unilateral Optic Neuropathy as the Presenting Symptoms of Vertebrobasilar DolichoectasiaCase Reports in Ophthalmological Medicine, 2013
- Microvascular decompression on patients with trigeminal neuralgia caused by ectatic vertebrobasilar artery complex: technique notesActa Neurochirurgica, 2012
- Dolichoectasia—an evolving arterial diseaseNature Reviews Neurology, 2011
- Role of Matrix Metalloproteinase Inhibitors in Preventing Abdominal Aortic AneurysmAnnals of Vascular Surgery, 2007
- Association of Small-Vessel Disease With Dilatative Arteriopathy of the BrainStroke, 2007
- Basilar megadolicho trunk causing obstructive hydrocephalus at the foramina of MonroSurgical Neurology, 2006
- Intracranial Bleeding in Patients With Vertebrobasilar DolichoectasiaStroke, 2005
- Is Breakdown of the Blood-Brain Barrier Responsible for Lacunar Stroke, Leukoaraiosis, and Dementia?Stroke, 2003
- Transcranial Doppler ultrasound for the assessment of intracranial arterial flow velocity—Part 2. Evaluation of intracranial arterial diseaseSurgical Neurology, 1987
- Ectasia of the basilar artery with special reference to possible pathogenesisSurgical Neurology, 1985