Mina Park1, Na-Young Shin2, Joonsang Yoo3, Ji Hoe Heo4, Jai Ho Choi5, Dong Young Cho5, Seung-Koo Lee6. 1. Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: nyshin@catholic.ac.kr. 3. Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Neurology, Keimyung Unversity School of Medicine, Daegu, Republic of Korea. 4. Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea. 5. Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 6. Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Abstract
OBJECTIVES: The purpose of this study was to evaluate the associations between vertebral artery hypoplasia (VAH) and the morphologic types of spontaneous vertebral artery dissection (sVAD) and to assess the chronological changes of VAH after sVAD. METHODS AND MATERIALS: In this retrospective study, we included 208 patients with 216 sVADs which were diagnosed between January 2003 and June 2017 at two tertiary hospitals. Morphologic types of sVAD were classified into aneurysmal dilatation without stenosis, pearl-and-string appearance, and steno-occlusion without aneurysmal dilatation. Baseline clinical characteristics and sVAD types were compared according to the presence of VAH on initial imaging. For 143 sVAD patients with follow-up imaging available, chronological changes of VAH and their associations with sVAD types were also evaluated. RESULT: VAH was detected in 29 (13.9%) subjects: 18 (8.7%) with ipsilateral VAH and 11 (5.3%) with contralateral VAH to the sVAD site. Primary lesion shape was statistically associated with the presence of VAH (P = 0.001); steno-occlusion without dilatation was more frequently observed in the ipsilateral VAH group (44.4%) than the no-VAH group (20.9%) or contralateral VAH group (0%). Of a total 143 sVAD patients with follow-up imaging available, VAH-like diffuse VA narrowing was newly observed in seven patients and four patients who were initially classified into the VAH group showed their VAH-like appearances resolved. CONCLUSIONS: The presence of VAH may be associated with the morphologic subtype of sVAD and the VA diameter can dynamically change, making it possible for the VAH-like appearance to be induced after a sVAD event.
OBJECTIVES: The purpose of this study was to evaluate the associations between vertebral artery hypoplasia (VAH) and the morphologic types of spontaneous vertebral artery dissection (sVAD) and to assess the chronological changes of VAH after sVAD. METHODS AND MATERIALS: In this retrospective study, we included 208 patients with 216 sVADs which were diagnosed between January 2003 and June 2017 at two tertiary hospitals. Morphologic types of sVAD were classified into aneurysmal dilatation without stenosis, pearl-and-string appearance, and steno-occlusion without aneurysmal dilatation. Baseline clinical characteristics and sVAD types were compared according to the presence of VAH on initial imaging. For 143 sVAD patients with follow-up imaging available, chronological changes of VAH and their associations with sVAD types were also evaluated. RESULT: VAH was detected in 29 (13.9%) subjects: 18 (8.7%) with ipsilateral VAH and 11 (5.3%) with contralateral VAH to the sVAD site. Primary lesion shape was statistically associated with the presence of VAH (P = 0.001); steno-occlusion without dilatation was more frequently observed in the ipsilateral VAH group (44.4%) than the no-VAH group (20.9%) or contralateral VAH group (0%). Of a total 143 sVAD patients with follow-up imaging available, VAH-like diffuse VA narrowing was newly observed in seven patients and four patients who were initially classified into the VAH group showed their VAH-like appearances resolved. CONCLUSIONS: The presence of VAH may be associated with the morphologic subtype of sVAD and the VA diameter can dynamically change, making it possible for the VAH-like appearance to be induced after a sVAD event.