Toward a Further Elucidation: Role of Vertebral Artery Hypoplasia in Acute Ischemic Stroke

• Published in: European neurology Vol. 55; no. 4; pp. 193 - 197
• Main Authors: Chuang, Yu-Ming, Huang, Yuarn-Chung, Hu, Han-Haw, Yang, Ching-Yih
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2006; S. Karger AG
• Subjects: Adult; Aged; Aged, 80 and over; Atherosclerosis - epidemiology; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Brain Ischemia - classification; Brain Ischemia - epidemiology; Brain Ischemia - physiopathology; Cerebrovascular Circulation - physiology; Congenital Abnormalities - epidemiology; Female; Humans; Incidence; Male; Medical sciences; Middle Aged; Neurology; Original Paper; Pharmacology. Drug treatments; Risk Factors; Stroke - classification; Stroke - epidemiology; Stroke - physiopathology; Vascular diseases and vascular malformations of the nervous system; Vertebral Artery - abnormalities; Vertebrobasilar ischemia; Vertebral artery, flow volume; Hypoplasia; Cerebral infarction; Stroke; Nervous system diseases; Cardiovascular disease; Vertebrobasilar; Cerebral disorder; Vascular disease; Ischemia; Malformation; Central nervous system disease; Vertebral artery; Cerebrovascular disease
• ISSN: 0014-3022; 1421-9913
• DOI: 10.1159/000093868

Background and Purpose: Congenital vertebral artery (VA) hypoplasia is an uncommon embryonic variation of posterior circulation. The frequency of this congenital variation was reported to be 2–6% from autopsy and angiograms. The aim of our study was to elucidate the role of VA hypoplasia in acute ischemic stroke. Method: We examined 191 acute ischemic stroke patients (age 55.8 ± 14.0 years). TOAST subtypes were determined. A cervical magnetic resonance angiogram was performed in every patient. A duplex study of bilateral VA with flow velocities and vessel diameter recording in the intertransverse (V2) segment was performed within 72 h after onset of ischemic stroke. The net VA flow volume was measured in each subject. Result: The overall incidence of a unilateral congenital hypoplastic VA was 11.51%, which was statistically higher especially in cases of brainstem/cerebellar infarction. Of these, subjects with VA hypoplasia had an etiological preponderance of the ‘large-artery atherosclerosis’ subtype and a topographic preponderance of ipsilateral posterior circulation infarction. Conclusions: Based on our results, VA hypoplasia seemed a contributing factor of acute ischemic stroke, especially in posterior circulation territories.