Vertebrobasilar Dolichoectasia And Posterior Circulation Ischemia

Background and objective:Vertebrobasilar dolichoectasia is a cerebrovascular disease that is still in exploring.Bacause of its low incidence,there are some difficulties in its studies and misdiagnosis in clinical diagnosis. Through this research we want to furher reserch into VBD about the incidence in ischemic stroke and posterior circulation ischemia,clinical and imagine feature in order to provide information for the early diagnosis ,prevention and relief the incidence of stroke.Methods:1. All objects were selected from the stroke patients at the neurology department of the first affilIiated hospital,Nanchang medical Universityd from October 2008 to February 2009. We have excluded patients with cerebral embolism, lacunar infarct and organic disease .We noted the age, sex, cigarettes,alcohol, the history of high blood pressure, diabetes , hyperlipoidemia,stroke, distribution of stroke vessels (anticirculation or postcirculation), imagine(the diameter of the BA,height of bifurcation, lateral displacement and shape deformities)and hemodynamic finding and reviewed retrospectively2. All patients was divided in anticirculation or postcirculation and VBD or not-VBD.VBD was diagnosed by board certified neuroradiologists, applying the computed tomography (CT) criteria of Smoker et al and MRI criteria of Giang et al, as MRA criteria of Ubogu et al.3. All datas were analysised by SPSS11.0 software.Results:1. The incidence of VBD accounts for 9.47% of ischemic stroke and 20.34% of posterior circulation ischemia in hospital at the same time.2. Ages ranged from 54~88 years with VBD, mean age was 70.38±10.58.The ages at symptom presentationis higher than not-VBD(P<0.05).Age and hypertention (P<0.01) are correlated with VBD. Sexuality, smoking,, alcoho, hyperglycemia, hyperlipoidemia ,strokes were not different in the two groups(all P>0.05). The diagnosis relied on the imagine of DSA or CTA or MRA or MRI ,acurations is 100% ,100%,75%,46.7%.3. Most of patients (75%) had posterior circulation ischemia.VBD is isolated risk factor of stroke(P<0.001).Infarts included the PCA and infratentorial lesions. Infratentorial lesions located mainly in the midpons.Conclusions:1. VBD are correlated with posterior circulation ischemia.2. VBD is an risk factor of posterior circulation ischemia.3. Age and hypertention are correlated with VBD4. Clinical and imaging findings is related to the diameter of the basilar artery, height of bifurcation, and transverse position.5. Many radiological examination methods can raise accuration in diagnose VBD.MRI is the preferred method joint MRA.