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Detection, cerebrovascular complications and risk factors associated with vertebrobasilar dolichoectasia: a scoping
Juan Morales-Verdugo1,2, Francisco Pérez-Rojas1,2, Alan Figueroa-Figueroa3
1Departamento de Ciencias Preclínicas, Facultad de Medicina, Universidad Católica del Maule, Talca, Chile.
Insights
Vertebrobasilar dolichoectasia increases cerebrovascular disease risk, particularly in posterior circulation. This condition, characterized by elongated and widened arteries, is linked to factors like hypertension and smoking.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Vertebrobasilar dolichoectasia (VBD) involves elongation and dilation of the vertebrobasilar system.
- Its association with cerebrovascular diseases (CVDs) and associated risk factors remains debated.
- A comprehensive synthesis of current evidence is needed.
Purpose of the Study:
- To analyze and synthesize literature on VBD.
- To review diagnostic criteria, risk factors, and CVD complications of VBD.
Main Methods:
- A scoping review adhering to PRISMA-ScR guidelines.
- Searches conducted in Web of Science, PubMed, and Scopus.
- Included studies on adult VBD diagnosed via CT/MRI, excluding those with coexisting neurological conditions.
Main Results:
- 18 studies with 3,058 participants were included.
- VBD components, with or without cardiovascular risk factors (hypertension, diabetes, smoking), elevate CVD risk.
- Posterior circulation, brainstem, cerebellum, thalamus, and occipital cortex are primarily affected.
Conclusions:
- VBD presence correlates with an increased risk of cerebrovascular disease.
- Further research is required to precisely quantify the risk associated with VBD components across different CVD types.
Introduction:
Vertebrobasilar dolichoectasia, a condition characterized by increased length, volume, and curvature of vertebrobasilar system, has been linked to an increased risk of cerebrovascular diseases. However, the evidence on its morphological components and risk factors for these diseases is contradictory. The lack of consensus about its characteristics, detection, cerebrovascular complications, or risk factors highlights the need for a review that synthesizes this information. Therefore, the purpose of this study was to analyze and synthesize the literature on diagnostic and detection criteria, risk factors and cerebrovascular complications associated with vertebrobasilar dolichoectasia.
Methods:
A scoping review was conducted following the PRISMA-ScR statement. The search was carried out in Web of Science, PubMed, and Scopus. Data on adult population with a confirmed diagnosis of vertebrobasilar tortuosity or dolichoectasia through computed tomography or magnetic resonance imaging compared with a control group were included, and excluding studies whose participants presented another neurological pathology coexisting with the cerebrovascular disease. The information was extracted, evaluated, and synthesized to provide a concrete view of the current evidence. Additionally, methodological quality was assessed with the Newcastle-Ottawa scale.
Results:
Of 1,373 identified studies, 18 met the eligibility criteria, including 3,058 participants (1,055 cases and 2003 controls). Vertebrobasilar dolichoectasia components, independently or associated with cardiovascular risk factors such as hypertension, atherosclerosis, diabetes, or smoking, are associated with a higher risk of cerebrovascular disease, mainly in the posterior circulation, affecting brain regions as brainstem, cerebellum, thalamus and occipital cortex.
Conclusion:
The findings suggest an increased risk of cerebrovascular disease when vertebrobasilar dolichoectasia or its components are present. More studies are necessary to quantify the risk of dolichoectasia components in different types of cerebrovascular disease.
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