Vertebrobasilar Dolichoectasia and Basilar Artery Dissection Presenting With Trigeminal Neuralgia: A Case Report

Wang, Yuhan; Cheng, Wenchao; Lian, Yajun

doi:10.3389/fneur.2019.00491

Cited by 5 publications

(2 citation statements)

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“…Vertebrobasilar dolichoectasia (VBD) is featured by ectasia, elongation, and tortuosity of the vertebrobasilar artery. Some case reports showed treatment options for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia, such as medications, microvascular decompression (MVD), Cyberknife stereotactic radiosurgery, and nerve blocks but not endoscopic-assisted MVD [ [4] , [5] , [6] , [7] , [8] ]. This paper aims to report successful endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

Duong

Pham

et al. 2021

International Journal of Surgery Case Reports

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Section: Introductionmentioning

confidence: 99%

Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

Duong

Pham

et al. 2021

International Journal of Surgery Case Reports

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“…The clinical manifestations of basilar dolichoectasia (BD) are variable. In addition to causing posterior circulation cerebral infarction and hydrocephalus, BD may cause hemifacial spasm [1] or trigeminal neuralgia [2] due to nerve compression. Mechanical compression by BD may affect the periaqueductal gray of the midbrain, the suprachiasmatic nucleus, hypothalamic-pineal axis function, or melatonin secretion, causing hypnic headache [3] .…”

Section: Introductionmentioning

confidence: 99%

Basilar dolichoectasia with intermural hematoma accompanied by cerebral microbleeds and white matter hyperintensities

Wang

Zhang

et al. 2021

Medicine

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Rationale:The clinical manifestations of basilar dolichoectasia (BD) are variable. The diagnosis is based on imaging measurements. Digital subtraction angiography displays only the dilated vascular lumen and lacks visualization of the arterial wall. High-resolution Magnetic resonance imaging (MRI) can identify intramural hematoma; therefore, it may be more suitable for the imaging evaluation of BD. However, most of the existing literature pertaining to BD lacks vascular wall assessment.Patient concerns:A 65-year-old Chinese man perceived weakness of the left upper and lower limb, double vision, dizziness, nausea, and vomiting was admitted to the emergency department. Fifteen years prior to this admission, he began taking levamlodipine besylate inconsistently for hypertension, but the level of blood pressure control was uncertain. The patient's father had a family history of hypertension.Diagnoses:An emergency axial computed tomography scan of the brain showed basilar artery (BA) dilation. Computed tomography angiography further indicated a maximum BA diameter of 38.94 mm. The length was >182 mm. MRI revealed acute infarctions of the right medulla oblongata and pons. Meanwhile, the patient had evidence of cerebral small vessel disease, including cerebral microbleeds and white matter hyperintensities. Whole-exome sequencing eliminated significant genetic variations consistent with clinical phenotypes. BD and intramural hematoma were further confirmed by high-resolution MRI of the arterial wall.Interventions:Atorvastatin was admitted according to the results of the high-resolution MRI of the arterial wall. Benidipine hydrochloride was selected as a long-term anti-hypertensive drug.Outcomes:The patient had no symptoms of neurological damage during 3-month follow-up.Lessons:Current evidence shows that BD has no obvious correlation with atherosclerosis. BA dissection and uncontrolled hypertension may be important factors in the progression of BD. BD-related stroke is likely to recur, and there are no standard secondary prevention measures. BD is often accompanied by cerebral microbleeds, and bleeding risk must be assessed during secondary prevention. When the BA diameter is greater than 10 mm, anti-platelet medication should be used with caution, blood pressure should be strictly controlled, and endovascular treatment should be considered.

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Research Progress in Endovascular Diagnosis and Treatment of Vertebrobasilar Dolichoectasia

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2023

ACM

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Vertebrobasilar Dolichoectasia and Basilar Artery Dissection Presenting With Trigeminal Neuralgia: A Case Report

Cited by 5 publications

References 19 publications

Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

Basilar dolichoectasia with intermural hematoma accompanied by cerebral microbleeds and white matter hyperintensities

Research Progress in Endovascular Diagnosis and Treatment of Vertebrobasilar Dolichoectasia

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