Department of Neurology, Teaching Hospital Nr. 1, Medical University of Lodz, Ul. Kopcińskiego 22, 90-153 Łódź, Poland.
Department of Neurology, Stroke and Neurorehabilitation, Medical University of Lodz, Ul. Kopcińskiego 22, 90-153 Łódź, Poland.
Int J Environ Res Public Health. 2022 Jul 29;19(15):9317. doi: 10.3390/ijerph19159317.
Vertebral artery hypoplasia (VAH) belongs to the relatively frequent Doppler ultrasonography (US) findings. However, its clinical significance remains controversial. This was a retrospective study analyzing clinical data of patients undergoing US because of cerebrovascular disease in a single academic neurology center. In the dataset of 2500 US examinations, 80 individuals with VAH (VA diameter < 2.0 mm) were identified (3.2% of all patients). Patients with significant vertebral artery asymmetry (SVAA, difference in VA diameters > 1.0 mm) (n = 80) and patients with normal VA diameter (n = 80) were also recruited. Clinical parameters including clinical signs and symptoms, concomitant diseases, imaging findings and the hospitalization outcome were compared between groups. The frequency of vertigo was highest in VAH group. Ischemic lesions of the cerebellum were found in 10% of VAH patients, 16% of SVAA patients and 5% of control subjects. Neurological deficits improved in over 60% of patients in each group, whereas ca. 30% of patients remained in a stable neurological status. The percentage of patients who deteriorated did not exceed 5% in any of the groups. The results of our study support a relatively high frequency of VAH. Our observations suggest coexistence of VAH with a higher frequency of neurological presentations associated with posterior arterial circulation of the central nervous system.
椎动脉发育不良(VAH)属于相对常见的多普勒超声(US)发现。然而,其临床意义仍存在争议。这是一项回顾性研究,分析了在单一学术神经病学中心因脑血管疾病接受 US 检查的患者的临床数据。在 2500 次 US 检查的数据集,80 例 VAH 患者(VA 直径<2.0mm)被识别(所有患者的 3.2%)。还招募了椎动脉明显不对称(SVAA,VA 直径差异>1.0mm)的患者(n=80)和 VA 直径正常的患者(n=80)。比较了各组之间的临床参数,包括临床体征和症状、伴随疾病、影像学发现和住院结局。VAH 组眩晕的频率最高。小脑缺血性病变在 10%的 VAH 患者、16%的 SVAA 患者和 5%的对照组患者中发现。每组中超过 60%的患者神经功能缺损得到改善,而约 30%的患者神经状态稳定。任何一组的恶化患者比例均不超过 5%。我们的研究结果支持 VAH 相对较高的发生率。我们的观察表明,VAH 与更频繁的与中枢神经系统后循环相关的神经表现并存。