Background
We aimed in this study to investigate the prevalence of vertebral artery hypoplasia
(VAH) in a population with isolated vertigo in association with stroke risk factors,
to determine whether VAH is an independent risk factor for posterior circulation infarction
(PCI).
Methods
We sequentially enrolled 245 patients with isolated vertigo with at least 1 vascular
risk factor, who were divided into PCI and non-PCI groups, according to present signs
of acute infarction on diffusion-weighted magnetic resonance imaging. All patients
underwent magnetic resonance angiography and cervical contrast-enhanced magnetic resonance
angiography to screen for VAH. Univariate and multivariate logistic regression analyses
were performed to identify the significant risk factors for PCI.
Results
VAH was found in 64 of 245 patients (26%). VAH (odds ratio [OR] = 2.70, 95%confidence
interval [CI] 1.17-6.23, P = .020), median stenosis of the posterior circulation (OR = 7.09, 95%CI = 2.54-19.79,
P < .001), and diabetes mellitus (OR = 3.13, 95%CI 1.38-7.12, P = .006) were independent risk factors for PCI. The predominant Trial of Org 10172
in Acute Stroke Treatment subtype in our patients with isolated vertigo with PCI complicated
by VAH was mainly small-artery occlusion.
Conclusions
Our findings suggest that VAH is an independent risk factor for PCI in patients with
isolated vertigo with confirmed risk from stroke.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Vertigo and dizziness in the elderly.Front Neurol. 2015; 6: 144
- Epidemiology of benign paroxysmal positional vertigo: a population based study.J Neurol Neurosurg Psychiatry. 2007; 78: 710-715
- Vulnerability of the vestibular organs to transient ischemia: implications for isolated vascular vertigo.Neurosci Lett. 2014; 558: 180-185
- Vascular vertigo: epidemiology and clinical syndromes.Neurologist. 2011; 17: 1-10
- Lateral medullary ischaemic events in young adults with hypoplastic vertebral artery.J Neurol Neurosurg Psychiatry. 2007; 78: 987-989
- Acute bilateral medial medullary infarct with hypoplastic vertebral artery.Clin Neurol Neurosurg. 2012; 114: 1365-1367
- Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts.J Neurol Neurosurg Psychiatry. 2009; 80: 1087-1092
- Evaluation of vertebral artery hypoplasia and asymmetry by color-coded duplex ultrasonography.Ultrasound Med Biol. 2004; 30: 605-609
- Vertebral artery hypoplasia is associated with a decrease in net vertebral flow volume.Ultrasound Med Biol. 2010; 36: 38-43
- Relationship between vertebral artery hypoplasia and posterior circulation stroke in Chinese patients.Neuroradiology. 2013; 55: 291-295
- Is vertebral artery hypoplasia a predisposing factor for posterior circulation cerebral ischemic events? A comprehensive review.Eur Neurol. 2013; 70: 78-83
- Toward a further elucidation: role of vertebral artery hypoplasia in migraine with aura.Eur Neurol. 2008; 59: 148-151
- Anomalous course and diameter of left-sided vertebral arteries—significance and predisposing factors in clinical practice.Ann Anat. 2014; 196: 360-364
- The clinical relevance of vertebral artery hypoplasia.Acta Neurol Taiwan. 2012; 21: 1-7
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke. 1993; 24: 35-41
- Carotid endarterectomy: the gold standard.J Endovasc Surg. 1996; 3: 10-15
- Vertebral artery hypoplasia: frequency and effect on cerebellar blood flow characteristics.Stroke. 2014; 45: 1363-1368
- Hypoplastic vertebral artery: frequency and associations with ischaemic stroke territory.J Neurol Neurosurg Psychiatry. 2007; 78: 954-958
- Lacunar strokes in patients with diabetes mellitus: risk factors, infarct location, and prognosis: the secondary prevention of small subcortical strokes study.Stroke. 2014; 45: 2689-2694
- Involvement of the basilar artery in diabetes mellitus: an MRI study of brainstem infarctions.Eur Neurol. 2010; 64: 230-235
- Possible morphological pathomechanisms of ischemic stroke in the posterior circulation of patients with vertebral artery hypoplasia.J Neuroimaging. 2015; 25: 408-414
- Differentiation between vertebral artery hypoplasia and occlusion.Intern Med. 2012; 51: 345
- Leukoaraiosis and NIHSS score help to differentiate subtypes of intracranial branch atheromatous disease in Southern Han Chinese patients with stroke.Neurol Sci. 2013; 34: 1727-1733
Article info
Publication history
Published online: October 13, 2016
Accepted:
September 13,
2016
Received in revised form:
August 17,
2016
Received:
June 25,
2016
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.020
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
