Basilar artery tortuosity as a predictive factor for the efficacy of heparin adjuvant therapy in unilateral idiopathic sudden sensorineural hearing loss

Vertebrobasilar Dolichoectasia in a patient with recurrent Sudden Sensorineural Hearing Loss. Diagnostic approach and dilemmas

“…According to Kim et al [18] SSNHL can be due to blood circulation disturbances in a stretched AICA deriving from a basilar artery which is curving contralaterally. Sunwoo [19] sustains the same hypothesis as in his study the severity of BA tortuosity correlated with occurrence of severe sudden hearing loss on the opposite side. Moreover, the pathomechanism of low wall sheer stress in the inner wall of a curved basilar artery and traction of the pontine perforators leading to formation of microthrombi is a possible explanation of the fact that pontine infarctions are more frequent on the side contralateral to BA curvature [20].…”

“…There are references about the existence of a dominant vertebral artery more frequently on the left side [18][19][20]. Despite the fact that hyperlipidemia and hypertension were present in the patient's recent medical history, (of a few years) the lateralization of the BA being evident many years earlier (Figure 2b) is in accordance with the pathogenetic theory of a mechanism other than atherogenesis, involving a disfunction of matrix metalloproteinases leading to aberrant vascular remodeling and abnormal connective tissue in the arterial wall [3,22].…”