Abstract
Goal: Intracranial arterial dissection is a major cause of ischemic stroke and subarachnoid
hemorrhage in relatively young patients. We assessed the hypothesis that the tortuosity
of the vertebrobasilar artery is associated with the occurrence of vertebral artery
(VA) dissection, using MR angiography (MRA). Materials and Methods: This study enrolled 43 patients with VA dissection, and 63 age- and sex-matched healthy
subjects were used as the controls. MRA was employed to evaluate the presence of dominant
VA and the lateral shift of vertebrobasilar junction in both groups. The VA diameters
were considered different when the difference was greater than .3 mm. These anatomical
variations were divided into 3 types: Type 1 (vertebrobasilar junction within 2 mm
from the midline), Type 2 (>2 mm-lateral shift of vertebrobasilar junction to the
ipsilateral side of the dominant VA), and Type 3 (>2 mm-lateral shift of vertebrobasilar
junction to the contralateral side of the dominant VA). Findings: The presence of dominant VA and the lateral shift of vertebrobasilar junction were
more prevalent in patients with VA dissection than in the controls (OR: 3.46, P = .013, and OR: 4.51, P = .001, respectively). The lateral shift of vertebrobasilar junction was classified
into Type 1 (n = 6), Type 2 (n = 13), and Type 3 (n = 17) among patients with VA dissection,
while into Type 1 (n = 20), Type 2 (n = 8), and Type 3 (n = 7) among the controls.
Type 3 predominance was observed in patients with VA dissection (P = .02). Conclusions: Anatomical variations of the vertebrobasilar artery may play an important role in
the occurrence of VA dissection.
Key Words
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Article info
Publication history
Published online: January 30, 2020
Accepted:
December 31,
2019
Received in revised form:
December 9,
2019
Received:
October 3,
2019
Footnotes
Grant Support: None.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104636
Copyright
© 2020 Elsevier Inc. All rights reserved.
