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[Dissections of the basilar artery]
H Urbach1, A Meyer-Lindenberg, M Bendszus
1Radiologische Klinik, Funktionseinheit Neuroradiologie Universität Bonn.
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|September 18, 1998
Summary
Basilar artery dissections present as two types: subintimal dissections causing vertebrobasilar ischemia and subadventitial dissections leading to subarachnoid hemorrhage. These findings aid in understanding basilar artery dissection presentations.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Basilar artery dissections are rare but critical vascular events.
- Understanding their diverse clinical presentations is crucial for timely diagnosis and management.
Observation:
- A study reviewed four patients with basilar artery dissections diagnosed via angiography.
- Clinical, radiological (angiography, MRI), and pathological data were correlated with patient outcomes.
Findings:
- Three patients exhibited subintimal dissections causing vertebrobasilar ischemia, with vessel wall irregularities noted on angiography.
- One patient presented with a post-traumatic basilar artery aneurysm.
- Autopsy in one case revealed a dissecting hematoma between the intima and media.
Implications:
- Basilar artery dissections can be classified into two main types based on pathological and clinical features.
- Subintimal dissections manifest as vertebrobasilar ischemia, often without the typical delay seen in extracranial dissections.
- Subadventitial dissections can lead to subarachnoid hemorrhage due to adventitial rupture.