Dissection of the vertebrobasilar artery

J Korean Neurol Assoc > Volume 15(3); 1997 > Article

Journal of the Korean Neurological Association 1997;15(3): 493-504.

추골기저동맥 박리

권오현, 윤병우, 김병곤, 노재규, 이한보, 박성호

서울대학교 의대 신경과, 서울 시립 보라매병원 신경과

Dissection of the vertebrobasilar artery

OH- Hyun Kwon, M.D., Byung-Woo Yoon, M.D., Byung-Gon Kim, M.D., Jae-Kyu Roh, M.D., Han-Bo Lee, M.D., Sung-Ho Park, M.D.

Department of Neurology, Seoul National University Hospital, Department of Neurology, Seoul City Borame Hospital

Abstract

In spite of relatively common references as differential diagnosis in the cases of vertebrobasilar ischemia or infartion, there are only a few reports about dissections of the vertebrobasilar artery(VBA) in Korea. We reviewed medical records and radiographic findings of the 10 patients diagnosed as having dissections of the VBA at Seoul National University Hospital and Seoul City Borame Hospitall since 1994. The 10 patients, all men ranging from 15 to 58 years, did not have the usual risk factors for stroke. In 6 cases, temporally related trauma or exercise was noted. There were also 2 cases of delayed neurologic manifestations from preceeding trauma, developed 74 days and about I year later respectively. Most subjects(9 cases) showed the ischemic symptoms of posterior circulations. Subarachnold hemorrhage was manifested in 2 cases. Magnetic resonance imaging(MRD, magnetic resonance angiography(MRA) and transfemoral cerebral angiography(TFCA) showed irregular narrowing of proximal vertebral artery(VA) with non-visualization of its distal part, thrombosed VA, intramural high signal intensity in VBA, double lumen appearance or fusiform aneurysm. Until now(mean follow up period; 15 months), them are no recurrences with anticoagulation or antiplatelet therapy in the cases of vertebrobasilar ischemia. Dissections of the VBA should be included in the differential diagnosis of vertebrobasilar ischemia or infarction, especially in the young population or in the subjects without common risk factors. The diagnosis can be made on the bases of clinical features and the characteristic findings of MRI, MRA and TFCA.