Incidence of unilateral distal vertebral artery aplasia: evaluation by combining basiparallel anatomic scanning-magnetic resonance imaging (BPAS-MRI) and magnetic resonance angiography

Morimoto, Kohei; Nagahata, Morio; Ono, Sachiko; Miura, Hiroyuki; Tsushima, Fumiyasu; Seino, Hiroko; Kakehata, Shinya; Basaki, Kiyoshi; Uno, Seiyu; Abe, Yoshinao

doi:10.1007/s11604-008-0313-0

Cited by 18 publications

(11 citation statements)

References 7 publications

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“…Codominance is the instance where there is symmetry of both arteries and found in 25% of individuals. The hypoplastic vertebral artery may terminate in PICA in .2% of individuals (Fig C) – Fenestration : …”

Section: Classification Of Normal Variantsmentioning

confidence: 99%

Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance

Hakim

Gralla

Rozeik³

et al. 2017

Journal of Neuroimaging

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Cerebral arteries may exhibit a wide range of variation from normal anatomy, which can be incidentally discovered during imaging. Knowledge of such variants is crucial to differentiate them from pathologies, to understand the etiology of certain pathologies directly related to a vascular variant, and to depict the changes in collateral circulation in patients with certain variants. Detection of particular variants may lead to the discovery of other nonvascular or vascular anomalies, especially aneurysms, and may also affect planning of endovascular or neurosurgical interventions. In this review, we summarize the variants and anomalies of cerebral arteries seen on cross-sectional imaging classified by a morphological approach and categorize their significance from a clinical perspective. This structured review is intended to serve as a guide for daily use in clinical practice.

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Section: Classification Of Normal Variantsmentioning

confidence: 99%

Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance

Hakim

Gralla

Rozeik³

et al. 2017

Journal of Neuroimaging

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“…The contralateral VA of this patient terminated in the PICA and, therefore, did not contribute to basilar and supratentorial perfusion. The frequency of unilateral distal VA aplasia has been reported as being 4.6% [7] .…”

Section: Treatment and Follow-upmentioning

confidence: 99%

Clinical Presentation, Magnetic Resonance Angiography, Ultrasound Findings, and Stroke Patterns in Patients with Vertebral Artery Dissection

Günther¹,

Witte²,

Freesmeyer³

et al. 2016

Eur Neurol

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Background/Aims: Vertebral artery dissection (VAD) is an important cause of ischemic stroke. In this observational study, clinical data, magnetic resonance (MR) and ultrasound (US) imaging findings and ischemic patterns were analyzed. Methods: Forty-seven patients with a diagnosis of VAD underwent clinical examination, US, MR of the brain and neck and MR angiography (MRA) of the cervical arteries. Vascular abnormalities and ischemic brain lesions were noted. Data were evaluated separately and compared for spontaneous and traumatic VAD subgroups. Results: The most common overall clinical symptom was vertigo followed by neck pain. In the traumatic subgroup, vertigo was relatively rare (p = 0.022). Most common MRA findings were vessel irregularity and vessel occlusions. Ischemic lesions occurred significantly more frequently after spontaneous than after traumatic VAD (p = 0.009). Unilateral VAD was significantly more common in non-dominant vertebral arteries (p < 0.001). Mortality after trauma was not only due to VAD complications but also due to other trauma-related injuries. Conclusion: The variability of MR and US imaging findings in patients with VAD is illustrated. The algorithm of management should be based on a multimodality approach involving patient history and clinical neurological examination. Several types of vessel abnormalities and ischemic lesion in diverse locations may point to arterial dissection, and the differential diagnosis of VAD must be kept in mind.

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“…Differentiation between congenital VAH and acquired atherosclerotic stenosis is difficult since it generally relies on the luminography including MRA, CTA or DSA. [ 7 8 9 10 11 ] None of these techniques could provide the precise morphology of the vessel wall of intracranial artery. HR MRI can directly visualize the arterial wall, permit identification of atherosclerotic plaques,[ 12 13 ] and help differentiate between acquired atherosclerotic stenosis and VAH.…”

Section: Discussionmentioning

confidence: 99%

“…This feature was very important for evaluation of tortuous intracranial vertebral arteries, which was difficult in the 2D image acquisition. [ 16 ] Recently, other magnetic resonance techniques, such as True Fast Imaging in Steady State Precession[ 7 ] or basiparallel anatomic scanning-MRI[ 8 9 ] were introduced to differentiate arterial occlusion from vertebral hypoplastic variants. However, such sequences still focused on the luminogram rather than the arterial wall, and could not clearly depict atherosclerotic lesions with excellent quality images, especially for VAH.…”

Section: Discussionmentioning

confidence: 99%

“…The differential diagnosis between VAH and stenosis might be difficult by the luminal imaging including digital subtract angiography (DSA), computer tomography angiography (CTA), and magnetic resonance angiography (MRA), as they only provide information on the luminal flow but not the morphological characteristics of vessel wall. [ 7 8 9 10 11 ] However, similar luminograms might reflect various underlying arterial wall lesions. Knowledge of wall characteristics will help further elucidate the mechanism of ischemic stroke in VAH patients.…”

Section: Introductionmentioning

confidence: 99%

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Wall Imaging for Unilateral Intracranial Vertebral Artery Hypoplasia with Three-dimensional High-isotropic Resolution Magnetic Resonance Images

Zhu

et al. 2015

Chinese Medical Journal

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Background:There are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia (VAH). The aim of this study was to determine wall characteristics of VAH with three-dimensional volumetric isotropic turbo spin echo acquisition (3D VISTA) images and differentiate between acquired atherosclerotic stenosis and VAH.Methods:Thirty patients with suspicious VAH by luminograms were retrospectively enrolled between January 2014 and February 2015. The patients were classified as “acquired atherosclerotic stenosis” or “VAH” based on 3D VISTA images. The wall characteristics of VAH were assessed to determine the presence of atherosclerotic lesions, and the patients were classified into two subgroups (VAH with atherosclerosis and VAH with normal wall). Wall characteristics of basilar arteries and vertebral arteries were also assessed. The clinical and wall characteristics were compared between the two groups.Results:Five of 30 patients with suspicious VAH were finally diagnosed as acquired atherosclerotic stenosis by 3D VISTA images. 25 patients were finally diagnosed as VAH including 16 (64.00%) patients with atherosclerosis and 9 (36.00%) patients with normal wall. In the 16 patients with atherosclerosis, plaque was found in 9 patients, slight wall thickening in 6 patients, and thrombus and wall thickening in 1 patient. Compared with VAH patients with normal wall, VAH patients with atherosclerosis showed atherosclerotic basilar arteries and dominant vertebral arteries more frequently (P = 0.000).Conclusions:Three-dimensional VISTA images enable differentiation between the acquired atherosclerotic stenosis and VAH. VAH was also prone to atherosclerotic processes.

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Incidence of unilateral distal vertebral artery aplasia: evaluation by combining basiparallel anatomic scanning-magnetic resonance imaging (BPAS-MRI) and magnetic resonance angiography

Abstract: We found that the frequency of aplastic unilateral VA was 4.6% in asymptomatic people using a combination of MRA and BPAS-MRI for assessment of an intracranial VA.

Cited by 18 publications

References 7 publications

Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance

Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance

Clinical Presentation, Magnetic Resonance Angiography, Ultrasound Findings, and Stroke Patterns in Patients with Vertebral Artery Dissection

Wall Imaging for Unilateral Intracranial Vertebral Artery Hypoplasia with Three-dimensional High-isotropic Resolution Magnetic Resonance Images

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