dolichoectasia treatment

BACKGROUND: Vertebrobasilar dolichoectasia, a rare vascular anomaly, rarely presents with hydrocephalus. The traditional treatment for hydrocephalus is a ventriculoperitoneal shunt. Conventional endoscopic third ventriculostomy can avoid shunt-related complications but is considered risky due to the presence of the dolichoectatic vessel. A sub-frontal extra-axial fenestration of the lamina terminalis can circumvent this anatomical constraint and can establish cerebrospinal fluid communication between the third ventricle and subarachnoid space...

Subarachnoid hemorrhage (SAH) due to ruptured posterior cerebral artery (PCA) intracranial arterial dolichoectasia (IADE) is very rare. As these lesions are difficult to treat microsurgically, neurointervention is preferred because the dolichoectatic artery does not have a clear neck, and the surgical field of view was deep seated with the SAH. However, in some cases, neurointervention is difficult due to anatomical variation of the blood vessel to access the lesion. In this case, a 30-year-old male patient presented with a ruptured PCA IADE and an aortic arch anomaly...

PURPOSE: Aim of this study is to evaluate safety and efficacy of flow diverters (FDs) in treatment of acutely ruptured posterior circulation aneurysms MATERIALS AND METHODS: Databases of three participating institutions were retrospectively scanned for patients in whom FD placement was attempted for treatment of acutely ruptured vertebrobasilar aneurysms. An interval of 14 days or fewer between the latest ictus and treatment was used as inclusion criterion. Patients with dolichoectasia of vertebrobasilar arteries were excluded...

INTRODUCTION: Dolichoectatic vessels can cause cranial nerve dysfunction by either direct compression or ischemia. Abducens nerve palsy due to neurovascular compression by elongated, enlarged, tortuous or dilated arteries is an uncommon but important cause. AIM: To highlight neurovascular compression as a cause of abducens nerve palsy and discuss various diagnostic techniques. METHODS: Manuscripts were identified using the National Institutes of Health PubMed literature search system...

BACKGROUND AND IMPORTANCE: Intracranial arterial dolichoectasia (or dilatative arteriopathy) is characterized by abnormal elongation, tortuosity, or increase in diameter of at least one of the main cerebral vessels. Dolichoectasia can be found incidentally or can present with cranial neuropathies (including vision loss) or stroke. Here, we describe the presentation and open surgical treatment of a patient with dolichoectasia of the intracranial internal carotid artery (ICA) causing monocular vision loss...

Trigeminal neuralgia is a rare condition characterized by brief, recurrent episodes of severe, unilateral, sharp pain limited to the sensory distribution of the trigeminal nerve. Neurovascular compression in the cisternal segment of the trigeminal nerve is considered the most common cause. Here, we present the case of an elderly man who had a two-year history of electric shock-like pain involving the right side of the face and associated facial spasms. The patient had a long-standing history of hypertension, diabetes mellitus, dyslipidemia, and previous coronary artery bypass graft surgery...

BACKGROUND: There are many causes of episodes of vertigo and very few causes of episodes of changes in taste, and the combination of the two is very rare. Here, we describe a patient with recurrent short episodes of vertigo in combination with simultaneous episodes of recurrent paroxysmal dysgeusia and altered feeling on the left side of face. The symptoms were caused by compression of the vestibulocochlear nerve and the facial nerve due to dolichoectasia of the basilar artery. METHODS: The patient was diagnosed in our routine clinical practice and underwent a complete neurological and neuro-otological examination, including video head impulse test, caloric irrigation, ocular and cervical vestibular evoked myogenic potentials, acoustic-evoked potentials, neuro-orthoptic examination, cranial MRI, and MR angiography...

OBJECTIVE: Vertebrobasilar artery nonsaccular aneurysms (VBANSAs) are associated with a 13% annual mortality. Revascularization and flow diversion are life-saving options in select cases; technical failures and rapid hemodynamic changes may contribute to unwanted outcomes. We describe a technique and report clinical outcomes of patients treated with an experimental slow-closing clip (SCC). METHODS: An experimental SCC was created to gradually close the parent artery of aneurysms...

Intracranial dolichoectasia mainly affects the posterior circulation in aging populations. It may develop into an aneurysmatic formation without a clear neck to be closed from circulation. These vertebrobasilar dolichoectatic artery aneurysms may lead to thromboembolic complications and mass effects on the brainstem and surrounding cranial nerves. Treatment is highly risky, especially in older patients with large or giant aneurysmatic formations. Vascular plasticity and collateral formation might stabilize aneurysmatic formation...

No abstract text is available yet for this article.

Vertebro-basilar dolichoectasia (VBD) is a rare pathology of unknown aetiology. Its clinical presentation is wide and prognosis is generally poor with a high mortality rate. Cerebral magnetic resonance imaging is the gold standard for diagnosis. We report an unusual case of intracranial dolichoectasia. VBD was revealed during investigation of a patient with altered mental status. CT brain imaging demonstrated severe obstructive hydrocephalus secondary to compression of the third ventricle. Management is always challenging and depends on the location and the mode of presentation...

Vertebrobasilar dolichoectasia (VBD) is characterized by significant expansion, elongation, and tortuosity of the basilar artery and vertebral artery. Certain highly selected cases of VBD can require intervention. Recent advances in endovascular treatment (EVT) have renewed hope for patients with VBD. However, which cases of VBD can benefit from EVT still needs to be determined. Currently, little is known regarding this matter. Therefore, we performed a review of the literature from a PubMed search and cataloged our experience regarding the classification and natural history of VBD and the prospects, prognosis and complications of EVT...

BACKGROUND: Giant dolichoectatic basilar trunk aneurysms have an unfavorable natural history and are associated with high morbidity, but their neurosurgical treatment is complex and challenging. METHODS: Flow reversal reconstruction with fourth-generation bypass and proximal vertebral artery clip occlusion is performed via orbitozygomatic craniotomy with the Kawase approach under rapid ventricular pacing. CONCLUSION: Fourth-generation bypass is an innovative, technically challenging, and clinically effective tool in the treatment armamentarium for giant dolichoectatic basilar trunk aneurysms...

OBJECTIVE: To systematize the data on diagnosis and treatment of non-saccular vertebrobasilar aneurysms. MATERIAL AND METHODS: We have analyzed modern and fundamental studies in the PubMed database for the period 1969-2020. The following keywords were used: non-saccular aneurysm, dolichoectasia, vertebrobasilar pool. Fifty-nine studies including 1 meta-analysis, 9 case reports, 24 reviews and 25 original articles were selected. RESULTS: Analysis of literature data indicates various unresolved problems associated with difficult diagnosis and choice of treatment that results high rates of disability and mortality...

BACKGROUND: Vertebrobasilar dolichoectasia (VBD) is a vasculopathy characterized by the elongation, widening, and tortuosity of a cerebral artery. Rarely, hydrocephalus results when the extended basilar artery impairs communication of the cerebral ventricle and cerebrospinal fluid dynamics. We experienced such a case when a patient underwent endoscopic third ventriculostomy (ETV) for noncommunicating hydrocephalus with VBD. CASE DESCRIPTION: A 54-year-old man presented with cognitive dysfunction and was diagnosed with VBD by magnetic resonance imaging (MRI)...

INTRODUCTION: Dolichoectasia is a form of brain large artery disease associated with a high risk of mortality and morbidity. Progressive enlargement of arterial size is a predictor of mortality, but there are no specific treatments for arresting or slowing down dilatation. Additionally, dilated brain arteries can cause flow stagnation, which can trigger thrombosis and cause stroke. Pathology and genetic studies indicate a possible role for increased matrix metalloproteinase activation in arterial dilatation and thus in the pathophysiology of dolichoectasia...

No abstract text is available yet for this article.

Trigeminal neuralgia (TN) due to vertebrobasilar dolichoectasia (VBD) is a rare disease that can be challenging to treat. The objectives of this study are to investigate the characteristics of patients with TN due to VBD and to analyze the efficacy of microvascular decompression (MVD) by the interposition method for treatment of the condition. From 2010 until 2020, the data of 30 patients with TN due to VBD who were treated with MVD by the interposition method were analyzed retrospectively. The characteristics of the patients were compared with those of patients with non-VBD TN (n = 815)...

Posterior circulation ischaemic stroke (PCIS) is a disease of high mortality and morbidity. They account for 20-25% of all ischaemic strokes. However, it is relatively under-researched and requires more clinical attention, since it carries worse functional outcomes. Vertigo, visual disturbances and sensory/motor disturbances are commonly observed in patients with PCIS. Large artery atherosclerosis and embolism are the main causes of PCIS, while there is growing evidence that vertebrobasilar dolichoectasia is a key associative factor...

Vertebral artery dolichoectasia may produce a variety of clinical scenarios depending on the level of compression of several nervous structures along its course. Despite the fact that the pathophysiology is not fully clarified, it would seem that this pathologic elongation and dilation of the artery are acquired and determined by a thinning of the internal elastic lamina exposed to chronic arterial hypertension or as a result of degeneration and atherosclerosis of the arterial wall with age. When treatment is indicated, several techniques to relieve compression have been proposed, but they are usually challenging and nonstandardized...