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dolichoectasia treatment

Hidetaka Arishima, Ken-Ichiro Kikuta
If the origin of isolated abducent nerve palsy cannot be found on neuroradiological examinations, diabetes mellitus is known as a probable cause; however, some cases show no potential causes of isolated abducent nerve palsy. Here, we report a 74-year-old male who suffered from diplopia due to isolated left abducent nerve palsy. Magnetic resonance angiography and fast imaging employing steady-state acquisition imaging clearly showed a dolichoectasic vertebrobasilar artery compressing the left abducent nerve upward and outward...
January 2017: Journal of Neurosciences in Rural Practice
P Bhogal, M Aguilar Pérez, O Ganslandt, H Bäzner, H Henkes, S Fischer
BACKGROUND AND PURPOSE: Non-saccular aneurysms of the posterior fossa are an uncommon pathology with no clear treatment strategy. The use of flow-diverting stents (FDS) has had mixed results. We sought to evaluate our experience of FDS for the treatment of this pathology. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated only with flow diversion for an unruptured non-saccular aneurysm of the posterior circulation between February 2009 and April 2016...
November 11, 2016: Journal of Neurointerventional Surgery
Vicente Vanaclocha, Juan Manuel Herrera, Deborah Martínez-Gómez, Marlon Rivera-Paz, Cristina Calabuig-Bayo, Leyre Vanaclocha
OBJECTIVE: Surgical treatment of trigeminal neuralgia (TN) associated with vertebrobasilar dolichoectasia is challenging. We analyze the treatments for this disease, discussing the advantages and drawbacks, and present our own technique and series. METHODS: This retrospective study covered the period January 2006 through January 2016. Vertebrobasilar dolichoectasia deviation from midline, basilar artery (BA) and vertebral artery diameter, and BA apex distance above the posterior clinoid process were measured on preoperative and postoperative magnetic resonance imaging...
December 2016: World Neurosurgery
Ignacio Arrese, Rosario Sarabia
INTRODUCTION: Vertebrobasilar dolichoectasia is a condition in which there is elongation and dilatation of the vertebral and basilar arteries. Few studies have been reported that focus on cases of trigeminal neuralgia (TN) secondary to vertebrobasilar dolichoectasia (VD) and treated by microvascular decompression (MD). PATIENTS AND METHODS: A case is presented of trigeminal neuralgia caused by vertebral artery compression. An analysis of the microsurgical technique, as well as a systematic review of the literature about this uncommon nerve compression is performed, in order to investigate, by pooled case analysis, if MD is a good option for this type of patient...
July 18, 2016: Neurocirugía
Arseny A Sokolov, Shakir Husain, Roman Sztajzel, Alexandre Croquelois, Johannes A Lobrinus, David Thaler, Claudio Städler, Hansjörg Hungerbühler, Valeria Caso, Gabriel J Rinkel, Patrik Michel
Vertebrobasilar dolichoectasia (VBD) is a chronic disorder with various cerebrovascular and compressive manifestations, involving subarachnoid hemorrhage (SAH). Occurrence of SAH shortly after worsening of clinical VBD symptoms has occasionally been reported. The goal of the study was to examine this association, in particular its pathophysiology, clinical precursor signs, time course, and outcome.To this end, in a retrospective multicenter study, we analyzed 20 patients with VBD and SAH in regard to preceding clinical symptoms, presence of vertebrobasilar thrombosis and ischemia, outcome and neuropathological correlates...
July 2016: Medicine (Baltimore)
Mustafa AbdelHamid, Kuruvilla John, Tanvir Rizvi, Nicholas Huff
Hemifacial spasm (HFS) happens because of vascular compression of the facial nerve at the root exit zone. Vertebrobasilar dolichoectasia (VBD) is a very rare cause of HFS. VBD is diagnosed by computed tomography angiography and magnetic resonance imaging. Here, we report a case of 65-year-old female patient with HFS due to VBD. We discuss the complications and the treatment options for the case.
December 2015: Radiology case reports
Ronald D Perrone, Adel M Malek, Terry Watnick
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. Relentless cyst growth substantially enlarges both kidneys and culminates in renal failure. Patients with ADPKD also have vascular abnormalities; intracranial aneurysms (IAs) are found in ∼10% of asymptomatic patients during screening and in up to 25% of those with a family history of IA or subarachnoid haemorrhage. As the genes responsible for ADPKD—PKD1 and PKD2—have complex integrative roles in mechanotransduction and intracellular calcium signalling, the molecular basis of IA formation might involve focal haemodynamic conditions exacerbated by hypertension and altered flow sensing...
October 2015: Nature Reviews. Nephrology
Vaso Zisimopoulou, Aikaterini Ntouniadaki, Panagiotis Aggelidakis, Anna Siatouni, Stylianos Gatzonis, Antonios Tavernarakis
Vertebrobasilar dolichoectasia is a clinical entity associated rarely with obstructive hydrocephalus. We present a 48-year old male with a profound dilatation of the ventricular system due to a dolichoectatic basilar artery, as appeared in imaging studies. The patient suffered from longstanding hydrocephalus and presenile dementia. The underlying mechanism for obstructive hydrocephalus due to vertebrobasilar dolichoectasia is considered to be both a water-hammer effect and a direct compression of adjacent structures...
April 24, 2015: Clinics and Practice
Fernando Pico, Julien Labreuche, Pierre Amarenco
Up to 12% of patients with stroke have intracranial arterial dolichoectasia (IADE) and the basilar artery is affected in 80% of these cases. Diagnostic criteria and prognosis studies of IADE are based on basilar artery diameter, which is a good quantitative marker for the severity of the disease. The pathophysiology is largely unknown, but IADE can be viewed as a common final pathway of arterial wall response or damage in the tunica media due to various mechanisms, such as matrix metalloproteinase dysfunction or muscle cell or elastic fibre injury...
August 2015: Lancet Neurology
Sudhir Datar, Giuseppe Lanzino, Alejandro A Rabinstein
BACKGROUND: Acute basilar artery occlusion is associated with poor outcome. In a few cases, occlusion occurs over a period allowing adequate collateral circulation to the posterior fossa. We describe a rare presentation with transient loss of consciousness (LOC) in a patient with extensive occlusion of the posterior circulation. METHODS: Case report. RESULTS: We describe a 70-year-old right-handed man with a history significant for atrial fibrillation and dolichoectasia of the basilar artery...
July 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Timothy Ryan Miller, Gaurav Jindal, Dheeraj Gandhi
Flow diversion is a promising technique for cerebral aneurysm treatment but presents new and sometimes unique challenges. Transient reversible narrowing due to device reconfiguration of the pipeline embolization device (PED) has not been previously described. Here we describe a patient with dolichoectasia of the distal right internal carotid artery with an associated saccular sidewall aneurysm who developed asymptomatic circumferential narrowing of the proximal aspect of the PED in the first month following deployment...
October 2015: Journal of Neurointerventional Surgery
Timothy Ryan Miller, Gaurav Jindal, Dheeraj Gandhi
Flow diversion is a promising technique for cerebral aneurysm treatment but presents new and sometimes unique challenges. Transient reversible narrowing due to device reconfiguration of the pipeline embolization device (PED) has not been previously described. Here we describe a patient with dolichoectasia of the distal right internal carotid artery with an associated saccular sidewall aneurysm who developed asymptomatic circumferential narrowing of the proximal aspect of the PED in the first month following deployment...
2014: BMJ Case Reports
Yong-Jie Yuan, Kan Xu, Qi Luo, Jin-Lu Yu
Vertebrobasilar dolichoectasia (VBD) is a rare disease characterized by significant expansion, elongation, and tortuosity of the vertebrobasilar arteries. Current data regarding VBD are very limited. Here we systematically review VBD incidence, etiology, characteristics, clinical manifestations, treatment strategies, and prognosis. The exact incidence rate of VBD remains unclear, but is estimated to be 1.3% of the population. The occurrence of VBD is thought to be due to the cooperation of multiple factors, including congenital factors, infections and immune status, and degenerative diseases...
2014: International Journal of Medical Sciences
P Brouwer, J Ligthart, E Regar
UNLABELLED: Optical Coherence Tomography (OCT) is an endovascular imaging modality that utilises infrared light to create high-resolution images of the vascular system. The use of OCT in cardiology is widely accepted and considered safe for imaging of the coronary artery wall, plaques and assessment of stent deployment. In the literature to date, OCT has not been used in endovascular imaging of neurovascular pathology. In this report we describe the first case in which OCT was used to evaluate pathology and assess the quality of the flow diverter treatment both directly after the treatment and at five months follow...
July 2014: Journal of Neurointerventional Surgery
Politei Juan, Amartino Hernan, Schenone Andrea Beatriz, Cabrera Gustavo, Michref Antonio, Tanus Eduardo, Dominguez Raul, Larralde Margarita, Blanco Mariana, Gaggioli Daniela, Szlago Marina
UNLABELLED: Fabry disease is an X linked disorder of metabolism due to deficient α-galactosidase A activity. Enzyme replacement therapy (ERT) with agalsidase Beta was approved by EMA in 2001 and FDA in 2003. PATIENTS AND METHODS: Six patients were enrolled. Baseline data was measured for renal, cardiac, and cerebrovascular functioning. We compared baseline quality of life scales with the current results. These parameters were assessed during the 10 years of follow-up period...
2014: JIMD Reports
Liemei Guo, Xiaohua Zhang, Jianwei Ge, Yongming Qiu
Intracranial dolichoectasia is an angiopathy characterized by dilation, elongation, and tortuosity of the cerebral arteries. It most frequently involves the vertebrobasilar arteries and carotid arteries, whereas a more peripheral location involving the anterior and the middle cerebral arteries (MCAs) is less frequent. We present a male patient with MCA dolichoectasia with radiologic follow-up for 3 years, and no ischemia or intracranial bleeding occurred after the antiplatelet therapy. From the reported case series of MCA dolichoectasia, we suggest that surgical procedure should not be adopted unless accompanied by aneurysm located at dolichoectatic MCA...
May 2014: Journal of Craniofacial Surgery
Yu-Wei Lin, Chih-Hung Chen, Ming-Liang Lai
Vertebrobasilar dolichoectasia (VBD) is a common phenomenon among people over 50 years old, and the related clinical expressions are varied. One of our VBD patients presented with brainstem infarction initially, received low molecular weight heparin treatment, and developed rupture of the dolichoectasia segment. Another patient with a similar-sized VBD experienced recurrent brainstem infarction three times over 2 years, despite higher bleeding tendency and long-term antiplatelet treatment. The third patient with a smallersized VBD, had left hemiplegia and received intravenous recombinant tissue plasminogen activator within 3 h, totally recovered with no lesions detected on brain Magnetic Resonance Imaging (MRI)...
October 12, 2012: Clinics and Practice
Jose Gutierrez, Sally Sultan, Ahmet Bagci, Tatjana Rundek, Noam Alperin, Mitchell S V Elkind, Ralph L Sacco, Clinton B Wright
BACKGROUND: Circle of Willis (COW) variants might influence arterial caliber in the brain. We hypothesized that these variants would be associated with the prevalence of intracranial dolichoectasia (DE). METHODS: We examined COW variants and DE in a sample of stroke-free participants (n = 436) undergoing magnetic resonance angiography (MRA) as part of a population-based study. Large intracranial arterial diameters were obtained when available; if not, the artery was defined as hypoplastic or absent according to its visibility on MRA...
2013: Cerebrovascular Diseases
Emily Nakagawa, Michael Hoffmann
Women are known to have particular heterogeneity in stroke etiology related to childbearing and hormonal factors. Although there are continued acute stroke treatment advances focusing on clot dissolution or extraction, effective secondary prevention of stroke, however, is dependent on an accurate etiological determination of the stroke. Otherwise, more strokes are likely to follow. Analysis of young women's stroke etiology in a large stroke registry incorporating contemporary neurovascular and parenchymal imaging and cardiac imaging...
2013: Neurology International
A Förster, J Ssozi, M Al-Zghloul, M A Brockmann, H U Kerl, C Groden
PURPOSE: Vertebrobasilar dolichoectasia (VBD) is a rare dilatative arteriopathy predominantly affecting the basilar artery (BA) and vertebral arteries. Until today, the value of computed tomography (CT)/CT angiography (CTA) compared with magnetic resonance imaging (MRI)/time-of-flight MR angiography (TOF-MRA) has not been studied systematically. METHODS: We (1) compare CTA and TOF-MRA according to the established criteria (diameter at the mid-pons level, height, and lateral position), (2) explore the value of further CTA- and TOF-MRA-derived measures (maximum transverse diameter and length), as well as (3) explore the value of further non-contrast-enhanced MRI sequences such as T1, fluid-attenuated inversion recovery, and T2* for a detailed characterization of VBD in a series of 18 patients...
December 2014: Clinical Neuroradiology
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