BACKGROUND: The clinical significance of vertebral artery hypoplasia (VAH) and the possible pathomechanism of ischemic stroke in patients with VAH are still not completely clear. METHODS: In a group of 80 posterior circulation strokes (PCS) patients, we compared the location of the ischemic areas in VAH (n = 26) and non-VAH (n = 54) group. We assessed the side of VAH (diameter equal to or less than 2.5 mm) with the stroke localization. RESULTS: The possible morphological stroke pathomechanisms in the VAH group--"blood flow reorganization" (n = 11) and "pathway liberation for embolization" (n = 10) - were represented equally and may also act together (n = 3). In two cases, the stroke pathomechanism was unknown. The frequency of the presence of conventional risk factors--hypertension (p = 1.0), diabetes mellitus (p = 0.62), hyperlipidemia (p= 1.0) and smoking (p = 1.0)--and the stroke etiology--cardioembolism (p = 0.80), atherosclerotic changes of large (p = 0.76) and small vessels (p = 0.79)--did not differ between the two subgroups. CONCLUSION: In patients with VAH, the combination of several pathomechanisms of ischemic stroke and the contribution of several risk factors can cause the clinical manifestation of PCS.
BACKGROUND: The clinical significance of vertebral artery hypoplasia (VAH) and the possible pathomechanism of ischemic stroke in patients with VAH are still not completely clear. METHODS: In a group of 80 posterior circulation strokes (PCS) patients, we compared the location of the ischemic areas in VAH (n = 26) and non-VAH (n = 54) group. We assessed the side of VAH (diameter equal to or less than 2.5 mm) with the stroke localization. RESULTS: The possible morphological stroke pathomechanisms in the VAH group--"blood flow reorganization" (n = 11) and "pathway liberation for embolization" (n = 10) - were represented equally and may also act together (n = 3). In two cases, the stroke pathomechanism was unknown. The frequency of the presence of conventional risk factors--hypertension (p = 1.0), diabetes mellitus (p = 0.62), hyperlipidemia (p= 1.0) and smoking (p = 1.0)--and the stroke etiology--cardioembolism (p = 0.80), atherosclerotic changes of large (p = 0.76) and small vessels (p = 0.79)--did not differ between the two subgroups. CONCLUSION: In patients with VAH, the combination of several pathomechanisms of ischemic stroke and the contribution of several risk factors can cause the clinical manifestation of PCS.