Risk Factors For Clinical Symptoms Of Vertebrobasialar Dolichoectasia

Background and Objective:At present,researches on VBD are mostly related to posterior circulation cerebral infarction or pay more attention to the imaging manifestations of VBD,while researches on other clinical manifestations and risk factors are relatively few,and the results are different,and as far as we know,there are no relevant reports on VBD in Inner Mongolia.As far as we know,there is no report on VBD in Inner Mongolia.In this study,we retrospectively collected patients who was admitted to the imaging department of our hospital and diagnosed withVBD.Aim to investigate its general situation,risk factors,clinical manifestations and imging findings.According to the clinical manifestation forms of VBD,it was divided into symptomatic group and asymptomatic group,further research on two groups of objects are compared,which is aimed to identify risk factors for clinical symptoms.We design to improve the understanding of VBD and provide strong evidence for secondary prevention.Material and Methods:From January 2017 to December 2018,all the patients who received brain Computed Tomography/CT angiography and/or head magnetic resonance imaging(MRI,3D-TOF MRA)at the imaging department of our hospital.We screened out patients who met the criteria for admission.The general situation,risk factors,clinical manifestations and imging findings were statistically analyzed,and the patients were further divided into symptomatic group and asymptomatic group according to their clinical manifestations.The grouping criteria was as follows:(1)symptomatic group including ischemic stroke,hemorrhagic stroke,brainstem compression type,cranial nerve compression type,hydrocephalus type;(2)asymptomatic group(except the clinical manifestations included in the symptomatic group).General date(gender,age),risk factors(blood pressure,blood lipids,blood glucose,homocysteine,uric acid,smoking,drinking history and coronary heart disease,etc.),clinical manifestations(posterior circulation transient ischemic attack,posterior circulation cerebral infarction,cerebral hemorrhage,subarachnoid hemorrhage,compression of brainstem or cranial nerve,hydrocephalus etc.)and imaging examinations(brain CT,CTA,brain MR)of the two groups patients were analyzed.Our aim is to find out the factors on symptomatic group.Results:1.Systolic blood pressure of patients in the symptomatic group was significantly higher than that in the asymptomatic group(wilcoxon W=594,P=0.000);The diastolic blood pressure of the symptomatic group was significantly higher than that in the asymptomatic group(wilcoxon W=657.5,P=0.000).2.The chief complaints of patients in the symptomatic group were limb weakness(15 cases,33.3%);The main complaints of the asymptomatic group were dizziness(22 cases,57.9%).3.The clinical distribution of patients in the symptomatic group was 24 cases of ischemic stroke,3 cases of hemorrhagic stroke,3cases of cranial nerve compression,5 cases of brain stem compression,and 1 case of hydrocephalus.Therefore,the clinical distribution of patients in the symptomatic group was mainly ischemic stroke,among which acute cerebral infarction was the most common.4.The diameter of basilar artery in the symptomatic group was larger than that in the asymptomatic group(wilcoxon W=779.0,P=0.044);The grade of basal artery bifurcation in the symptomatic group was higher than that in the asymptomatic group(X~2=8.825,P=0.032).Conclusions:1.The comparison of arterial systolic pressure and diastolic pressure between the two groups was statistically different,so high blood pressure was a risk factor for clinical symptoms.2.The diameter of basilar artery between the two groups was statistically different,suggesting that the increase of basilar artery diameter was a risk factor for clinical symptoms.3.The difference between the two groups was statistically significant,suggesting that the high grade of basilar artery bifurcation height was a risk factor for clinical symptoms.