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"Dolichoectatic Vertebrobasilar Artery Aneurysms"
Behnam Rezai Jahromi1, Mika Niemelä1
1Department of Neurosurgery, Helsinki University Hospital & University of Helsinki, Helsinki, Finland; Töölö Hospital, Topeliuksenkatu 5, Helsinki 00260, Finland.
Neurosurgery Clinics of North America
|October 13, 2022
Summary
Intracranial dolichoectasia, often in older adults, involves enlarged posterior circulation arteries that can form wide-necked aneurysms. These aneurysms pose risks of stroke and neurological damage, with treatment being highly complex.
Area of Science:
- Neurology
- Vascular Medicine
- Geriatrics
Background:
- Intracranial dolichoectasia primarily impacts the posterior circulation in aging individuals.
- It can progress to wide-necked aneurysms, posing significant clinical challenges.
- These aneurysms are associated with thromboembolic events and mass effects on neural structures.
Purpose of the Study:
- To review the current understanding of intracranial dolichoectasia, focusing on vertebrobasilar dolichoectatic artery aneurysms.
- To discuss the potential complications, treatment risks, and natural history of this condition.
- To explore factors influencing aneurysm stability, such as vascular plasticity.
Main Methods:
- Literature review of studies on intracranial dolichoectasia and vertebrobasilar aneurysms.
- Analysis of clinical presentations, diagnostic challenges, and therapeutic outcomes.
- Examination of pathophysiological mechanisms and potential stabilizing factors.
Main Results:
- Vertebrobasilar dolichoectatic artery aneurysms present a high risk for thromboembolic complications and mass effects.
- Treatment is particularly hazardous in elderly patients with large or giant aneurysms.
- Vascular plasticity and collateral circulation may play a role in stabilizing these aneurysms.
Conclusions:
- The etiology and natural history of intracranial dolichoectasia remain poorly understood.
- Optimal treatment strategies for vertebrobasilar dolichoectatic artery aneurysms require further investigation.
- Further research is needed to elucidate the disease's progression and identify effective management approaches.
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