[Vertebrobasilar dolichoectasia]

Vertebro-basilar dolichoectasia is an anomaly which has been well-known since the earliest days of clinical neurology. In spite of this neither the mechanism by which it is produced not its clinical importance are fully defined. In this paper we review basic clinical aspects of this pathology.

In most cases the subjacent arteriopathy is arteriosclerotic. The clinical features are very varied and it may be asymptomatic. Sometimes the clinical findings are due to compression of adjacent structures, basically the cranial nerves. Trigeminal neuralgia and hemifacial spasm are the commonest findings. There is usually only one presenting symptom but several symptoms may occur at the same time. On other occasions the patients present with cognitive deficits; there is no obvious relationship of cause and effect between vertebro-basilar dolichoectasia and cognitive deterioration. Finally, there seems to be a predisposition to cerebrovascular accidents. Most cerebrovascular accidents associated with dolichoectasia are ischemic, although some are hemorrhagic. Nevertheless, from the point of view of prognosis, the importance of vertebro-basilar dolichoectasia is not completely clear. At the present time, there are no therapeutic attitudes which are specific for this anomaly.

Further studies of the practical results of detection of this anomaly and its natural history are necessary.