Ectasia da artéria basilar e acidente vascular cerebral: aspectos clínicos de 21 casos

Abstract

Ectasia of the basilar artery (EB) occurs when its diameter is greater than normal along all or part of its course, and/or when it is abnormally tortuous. EB may cause cranial nerve dysfunction, ischemic stroke or subarachnoid hemorrhage, pseudotumor or hydrocephalus. We tried to describe cases of stroke associated with EB, analyze its frequency, clinical aspects, and the mechanisms involved in different forms of its presentation. We found 21 patients with stroke and EB. The association between EB and stroke was more prevalent in males over the age of fifty. Main symptoms were hemiparesia, cranial nerves dysfunction, and cerebellar ataxia. Cerebral infarcts associated with EB were due to different mechanisms: arterial thrombosis, artery-to-artery embolism, mass effect with angulation and obstruction of the vertebral and basilar branches.

Giant aneurysm of the basilar artery in an 86 year old woman

“…Brainstem infarction may result from occlusion of the pontine perforators due to hypertensive arteriosclerosis, which may lead to perforating artery disease 11 . A possibility is that extrinsic compression by the expanding giant aneurysm led to occlusion of the pontine perforators, although artery-to artery embolism occurs relatively often in patients with giant basilar aneurysms 12 .…”

The Effect of Microvascular Decompression for Hemifacial Spasm Caused by Vertebrobasilar Dolichoectasia

“…VBD is a rare arteriopathy characterized by elongation and enlargement of the vertebrobasilar artery with subsequent thrombosis, micro-embolization, and brainstem compression, with or without aneurysm formation6,11,12,16,18,21,31,34,35). This arteriopathy is known to cause variable neurologic deficits, including combined brainstem and cranial nerve syndromes3,6,7,12,24,31), cervicomedullary junction compression12,16,18,20,31,33) transient or permanent motor deficits12,16,20,21,23,35), cerebellar dysfunction16), central sleep apnea22), hydrocephalus, ischemic stroke33,35), and subarachnoid hemorrhage5,8,26).…”

“…This arteriopathy is known to cause variable neurologic deficits, including combined brainstem and cranial nerve syndromes3,6,7,12,24,31), cervicomedullary junction compression12,16,18,20,31,33) transient or permanent motor deficits12,16,20,21,23,35), cerebellar dysfunction16), central sleep apnea22), hydrocephalus, ischemic stroke33,35), and subarachnoid hemorrhage5,8,26). VBD is a potentially serious condition that may cause severe disability due to ischemic or compressive dysfunction in the posterior fossa27,32).…”