Zhu Wei, Wang Ya-Fang, Dong Xiao-Feng, Feng Hong-Xuan, Zhao He-Qing, Liu Chun-Feng
Department of Neurology, Second Affiliated Hospital Institute of Neuroscience, Soochow University, 1055, Sanxiang Road, Suzhou, 215004, China.
Department of Neurology, Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), 26, Daoqian Street, Suzhou, 215002, China.
Acta Neurol Belg. 2016 Sep;116(3):287-93. doi: 10.1007/s13760-015-0570-5. Epub 2015 Nov 28.
Vertebral artery dominance (VAD), which is a common congenital variation of vertebral artery, may be associated with an increased risk of cerebral posterior circulation infarction (PCI). The aims of this study were to investigate the correlation of VAD with incidence and laterality of PCI, and oblige the correlation of VAD and basilar artery (BA) curvature. Incidence of separate territory infarction in posterior circulation and incidence of BA curvature were compared between 78 VAD patients and 68 controls. VA dominance, laterality of BA curvature and separate territory infarction, and their directional relationships were observed in VAD group. The incidence of BA curvature in VAD group was significantly higher than that in controls (P = 0.000). 89.7 % (35/39) of patients had an opposite directional relationship between dominant VA and BA curvature. The total incidence of PCI in VAD group was significantly higher than that in controls (P = 0.001). The incidences of posterior inferior cerebellar artery (PICA) and BA territory infarction were both significantly higher than those in controls [11.5 % (9/78) vs. 1.5 % (1/68), P = 0.016; 20.5 % (16/78) vs. 7.4 % (5/68), P = 0.024]. No differences were found in superior cerebellar artery and posterior cerebral artery territory infarction between two groups. 77.8 % (7/9) of PICA infarction were on the opposite side of dominant VA. 75.0 % (12/16) of BA infarction were on the side of dominant VA. The incidence of PCI in BA curvature patients was significantly higher than that in BA straight patients. The incidence of BA curvature is higher in VAD patients, and BA usually bends to the opposite side of dominant VA. The incidence of PCI is higher in VAD patients, especially in PICA infarction and BA infarction patients.
椎动脉优势(VAD)是椎动脉常见的先天性变异,可能与脑后循环梗死(PCI)风险增加有关。本研究的目的是探讨VAD与PCI发生率及梗死侧别的相关性,并明确VAD与基底动脉(BA)弯曲度的相关性。比较了78例VAD患者和68例对照者后循环不同区域梗死的发生率及BA弯曲度。观察VAD组的椎动脉优势、BA弯曲度及梗死区域的侧别及其方向关系。VAD组BA弯曲度的发生率显著高于对照组(P = 0.000)。89.7%(35/39)的患者优势椎动脉与BA弯曲度呈相反方向关系。VAD组PCI的总发生率显著高于对照组(P = 0.001)。小脑后下动脉(PICA)和BA区域梗死的发生率均显著高于对照组[11.5%(9/78)对1.5%(1/68),P = 0.016;20.5%(16/78)对7.4%(5/68),P = 0.024]。两组小脑上动脉和大脑后动脉区域梗死发生率无差异。77.8%(7/9)的PICA梗死位于优势椎动脉对侧。75.