Vertebral artery dominance affects basilar artery curvature and vertebrobasilar junctional infarct

Abstract

Objective To investigate the effect of vertebral artery (VA) dominance on basilar artery (BA) curvature and pontine or cerebellar infarct occurring around the vertebrobasilar junction of VA. Methods Radiological data (infarct laterality,VA dominance,BA curvature and their directional relationships) were analyzed in 91 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarcts.Multiple regression analysis was performed to predict the moderate to severe BA curvature. Results The dominant VA frequently happened on the left side.Most patients had an opposite directional relationship between the dominant VA and BA curvature. Pontine infarct frequently happened opposite to the side of BA curvature and PICA infarct on the same side as the non-dominant VA side.The VA diameter was the only independent predictor for moderate to severe BA curvature (OR: 2.70; 95％CI: 1.22-5.98). Conclusion VA dominance is an important predictive factor of BA curvature,and BA curvature is usually opposite to the side of BA curvature; VA dominance and BA curvature caused by VA dominance increase the incidence of vertebrobasilar junctional infarcts. Key words: Vertebral artery dominance; Basilar artery curvature; Cerebral infarct