Clinical characteristics and imaging analysis of vertebrobasilar dolichoectasia

Abstract

To discuss the clinical characteristics and imaging findings so as to improve the understanding of vertebrobasilar dolichoectasia (VBD). The clinical profiles of 25 VBD patients diagnosed by magnetic resonance imaging (MRI) were retrospectively collected during January 2009-January 2010. Their clinical characteristics and imaging findings were analyzed. (1) Clinical characteristics: Posterior circulation ischemia (84%) was predominant. Different degrees of dizziness (40%) was the most common clinical manifestation. (2) Imaging analysis: two cases (8%) had a missed diagnosis by head computerized tomography. The diagnostic accuracy rate of head MRI and MRA was 100%. The degree of bifurcation height or lateral deviation of basal artery was mainly of the 2nd degree according to the Smoke's criteria. The lateral deviation of basal artery was mostly of a rightward shift (60%). The medulla oblongata was often compressed to deformation (40%). Basal artery calcification (12%) and VBD-associated hydrocephalus (4%) were rare. VBD was usually complicated with arteriosclerosis plaques of intracranial arteries in posterior circulation (> 40%). (3) Follow-up results: three cases (12%) suffered serious brainstem infarction during a follow-up period of 0.5 - 1.5 years. Two (8%) of them were dead. The degree of bifurcation height or lateral deviation of basal artery was of the 3rd degree in 3 cases. The clinical manifestations of VBD are multiple. But posterior circulation ischemia is not rare, especially for the elderly patients. Because of a high rate of disability and mortality, early diagnosis is essential. MRI is of a great value in confirming the diagnosis and evaluating the prognosis.