Vertebrobasilar Dolichoectasia: Clinical Neuroimaging Correlation

Abstract

ABSTRACT:BACKGROUND: Vertebro-basilar dolichoectasia (VBD) is an uncommon vasculopathy of unclear origin affecting the arterial wall of vertebral artery (VA) and basilar artery (BA). A variety of clinical syndromes and neuroimaging features have been associated with VBD. OBJECTIVE: This cross sectional study is conducted to shed a light on the neuroimaging signs of VBD and explore the association between the clinical presentation and imaging parameters of VBD in patients clinically suspected to have VBD with neuroimaging diagnosis. MATERIAL AND METHODS: This randomized cross sectional study was performed in Middle Euphrates Neuroscience Centre in Annajaf city between April 2012 to December 2012,A 34 patients with neuroimaging diagnosis of VBD (18 patients by MRI and 16 patients by MDCT) were included, VBD were assessed by studying the basilar artery width (BAW), bending length (BL) and level of basilar artery bifurcation according to Dan Deng et al criteria. The findings were correlated with patient clinical presentation.RESULTS: Thirty four patients, (24 males & 10 females) with age range between 25-81 years and mean of 57.9 year were included in this study. Among all presenting symptoms, only headache showed statistically significant association (p value <0.05) with the width of the basilar artery. There was higher prevalence of single cranial nerve involvement (SCNI) in patients with more tortuous basilar artery (55.5% of those with BL more or equal to 10 mm versus 16% of those less than 10 mm) with statistically significant association (p value <0.05), suprasellar extension was seen in 26.4% of cases and showed significant association with headache and visual symptoms. CONCLUSION: VBD is an important clinical entity and could be associated with or responsible for many serious clinical presentations, special attention is needed for VBD diagnosis and it's parameter during evaluation of brain imaging especially in patients with un-explained or vague presentation.