Sauer Tamara, Wolf Marc E, Ebert Anne D, Szabo Kristina, Chatzikonstantinou Anastasios
Department of Neurology, Universitaetsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
Department of Neurology, Universitaetsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
J Stroke Cerebrovasc Dis. 2016 Jul;25(7):1770-1775. doi: 10.1016/j.jstrokecerebrovasdis.2016.03.050. Epub 2016 Apr 18.
Vertebral artery hypoplasia (VAH) is common, but its role in acute ischemic stroke (AIS) is uncertain. We aimed to evaluate the frequency, characteristics, and role of VAH in a large typical cohort of patients with AIS.
Up to 815 AIS patients (52.8% men, mean age 70 ± 14 years) were included in the study. All patients received a stroke work-up including brain imaging and duplex ultrasound. VAH was defined by a vessel diameter of less than or equal to 2.5 mm or a difference to the contralateral side of greater than 1:1.7. Vascular risk factors and stroke features were recorded. The subgroup of patients with posterior circulation AIS and magnetic resonance imaging was analyzed additionally, including the parameter of stroke extent.
Up to 111 patients (13.6%) had VAH, with a mean diameter of 2.4 ± .4 mm. Patients with VAH were significantly younger (P = .037) and more often male (P = .033). There was no difference considering the National Institutes of Health Stroke Scale and modified Rankin Scale scores on admission or history of stroke. The distribution of patients without VAH was significantly different among the groups with anterior, posterior, and both circulations ischemia (P = .009). In the group with posterior circulation stroke, 36 patients (20.9%) had VAH. There were no differences in age, sex, history of stroke, risk factors, vascular territory, stroke size, or etiology. VAH patients had less often embolic stroke patterns (P = .009).
VAH is more common in patients with posterior circulation stroke and in younger patients. Apart from that, we found no clear evidence that VAH would be a predisposing factor for stroke or that it increased the risk for larger ischemic lesions in the posterior circulation.
椎动脉发育不全（VAH）很常见，但其在急性缺血性卒中（AIS）中的作用尚不确定。我们旨在评估VAH在一大组典型AIS患者中的发生率、特征及作用。
本研究纳入了多达815例AIS患者（男性占52.8%，平均年龄70±14岁）。所有患者均接受了包括脑成像和双功超声在内的卒中检查。VAH的定义为血管直径小于或等于2.5毫米，或与对侧相比差值大于1:1.7。记录血管危险因素和卒中特征。另外对后循环AIS患者及磁共振成像亚组进行了分析，包括卒中范围参数。
多达111例患者（13.6%）存在VAH，平均直径为2.4±0.4毫米。VAH患者明显更年轻（P = 0.037），且男性更多见（P = 0.033）。入院时美国国立卫生研究院卒中量表和改良Rankin量表评分或卒中病史方面无差异。无前循环、后循环及双循环缺血的各组中，无VAH患者的分布存在显著差异（P = 0.009）。在后循环卒中组中，36例患者（20.9%）存在VAH。在年龄、性别、卒中病史、危险因素、血管区域、卒中大小或病因方面无差异。VAH患者出现栓塞性卒中模式的情况较少（P = 0.009）。
VAH在后循环卒中患者及年轻患者中更常见。除此之外，我们没有发现明确证据表明VAH是卒中的诱发因素，或其会增加后循环中更大缺血性病变的风险。
