The Correlation Between Vertebral Artery Dominance And Transient Ischemic Attack

Research backgroadNew medical research center of England in twentieth Century 80 in the posterior circulation ischemia (PCI) registry studies have a thorough understanding of the etiology and pathogenesis of posterior cerebral circulation ischemia, the posterior circulation ischemia has been replaced by the concept of vertebrobasilar insufficiency. Our experts defined posterior circulation ischemia as:posterior circulation cerebral infarction and transient ischemic attack. In fact, because the concept of posterior circulation ischemia medical is not unified, the majority of patients with clear posterior circulation are not diagnosied according to the standard of posterior circulation ischemia.In clinical posterior circulation transient ischemic attack is equivalent to the posterior circulation ischemia. The concept of vertebral artery dominance:one side vertebral artery diameter was significantly greater than that in the contralateral vertebral artery or although the diameters are considerable,the connection of one side of vertebral artery and basilar artery is more directly, and the non dominant side of vertebral artery showed full uniform slender. Clinical significance of vertebral artery dominance is unclear, both the study of the relationship between PCI and VAD is less at home and abroad. We can take measures to prvent the incidence of posterior circulation transient ischemic attack caused by vertebral artery dominance.Purpose:To explore the significance of lateral vertebral artery dominance in patients with transient ischemic attack(TIA).Methods:1. Totally 231 patients with TIA treated in the Department of Neurology of our hospital from January 2012 to June 2013 were enrolled in this study.2. According to the ABCD2 Score, these subjects were divided into three group:low-risk group(72 cases), moderate-risk group(91 cases) and high-risk group(68 cases). Vertebral artery dominance(VAD) was detected using magnetic resonance angiography. Correlation between TIA and VAD and their odds ratio (OR) were analyzed.Results1. The lateral VAD was found in 20 patients(18.1%) of low-risk group, 41patients(35.2%) ofmoderate risk group, and 44 patients(54.4%) of high-risk group. The incidence was significantly higher in high-risk group than in morderate-risk group and low-risk group(X2=6.040, P=0.0163; X2= 5.124, P=0.034). The risk of lateral VAD was much higher in high-risk group than in morderate-risk group (OR=2.236,95%CI1.171-4.2684), and morderate-risk group higher than low-risk group (OR=2.132,95% CI1.101～ 4.128)ConclusionsThe lateral VAD was associated with TIA, and played an important role in TIA.