Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms
The etiology of the vertebral dissecting aneurysms is largely unknown, and they frequently occurs in relatively healthy young men. Objectives and Methods. A series of 57 consecutive cases defined by angiography were evaluated with regard to deviation in the course of the affected and contralateral v...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2012/716919 |
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| author | Akira Kurata Sachio Suzuki Kazuhisa Iwamoto Kuniaki Nakahara Katsutoshi Abe Madoka Inukai June Niki Makoto Sasaki Kiyotaka Fujii Shingo Konno Shinichi Kan Kazuaki Fukasaku |
| author_facet | Akira Kurata Sachio Suzuki Kazuhisa Iwamoto Kuniaki Nakahara Katsutoshi Abe Madoka Inukai June Niki Makoto Sasaki Kiyotaka Fujii Shingo Konno Shinichi Kan Kazuaki Fukasaku |
| author_sort | Akira Kurata |
| collection | DOAJ |
| description | The etiology of the vertebral dissecting aneurysms is largely unknown, and they frequently occurs in relatively healthy young men. Objectives and Methods. A series of 57 consecutive cases defined by angiography were evaluated with regard to deviation in the course of the affected and contralateral vertebral arteries. Division was into 3 types: Type I without any deviation, Type II with mild-to-moderate deviation but not over the midline; and Type III with marked deviation over to the contralateral side beyond the midline. Results. The most frequent type of VA running was Type III for the affected and Type I nonaffected side, with this being found in all 17 patients except one. All of the Type III dissections occurred just proximal to a tortuous portion, while in cases with Type-I- and Type-II-affected sides, the majority (33 of 39) occurred near the union of the vertebral artery. In 10 of 57, a non-dominant side was affected, all except one being of Type I or II. With 12 recent patients assessed angiographically in detail for hemodynamics, eleven patients showed contrast material retrograde inflowing into the pseudolumen from the distal portion of the dissection site. Turbulent blood flow was recognized in all of these patients with retrograde inflow. Conclusions. Turbulent blood flow is one etiology of vertebral artery dissection aneurysms, with the sites in the majority of the cases being just proximal to a tortuous portion or union of vessels. In cases with dissection proximal to the tortuous course of the vertebral artery, retrograde inflow will occur more frequently than antegrade, which should be taken into account in designing therapeutic strategies. |
| format | Article |
| id | doaj-art-b1d0906788fd480c870024a9680a44da |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-b1d0906788fd480c870024a9680a44da2025-02-03T06:06:42ZengWileyStroke Research and Treatment2090-81052042-00562012-01-01201210.1155/2012/716919716919Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting AneurysmsAkira Kurata0Sachio Suzuki1Kazuhisa Iwamoto2Kuniaki Nakahara3Katsutoshi Abe4Madoka Inukai5June Niki6Makoto Sasaki7Kiyotaka Fujii8Shingo Konno9Shinichi Kan10Kazuaki Fukasaku11Department of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, JapanDepartment of Critical Care Medicine, Kitasato University School of Medicine, JapanDepartment of Radiology, Kitasato University School of Medicine, JapanBio-Research Infrastructure Construction Team, RIKEN, Saitama, JapanThe etiology of the vertebral dissecting aneurysms is largely unknown, and they frequently occurs in relatively healthy young men. Objectives and Methods. A series of 57 consecutive cases defined by angiography were evaluated with regard to deviation in the course of the affected and contralateral vertebral arteries. Division was into 3 types: Type I without any deviation, Type II with mild-to-moderate deviation but not over the midline; and Type III with marked deviation over to the contralateral side beyond the midline. Results. The most frequent type of VA running was Type III for the affected and Type I nonaffected side, with this being found in all 17 patients except one. All of the Type III dissections occurred just proximal to a tortuous portion, while in cases with Type-I- and Type-II-affected sides, the majority (33 of 39) occurred near the union of the vertebral artery. In 10 of 57, a non-dominant side was affected, all except one being of Type I or II. With 12 recent patients assessed angiographically in detail for hemodynamics, eleven patients showed contrast material retrograde inflowing into the pseudolumen from the distal portion of the dissection site. Turbulent blood flow was recognized in all of these patients with retrograde inflow. Conclusions. Turbulent blood flow is one etiology of vertebral artery dissection aneurysms, with the sites in the majority of the cases being just proximal to a tortuous portion or union of vessels. In cases with dissection proximal to the tortuous course of the vertebral artery, retrograde inflow will occur more frequently than antegrade, which should be taken into account in designing therapeutic strategies.http://dx.doi.org/10.1155/2012/716919 |
| spellingShingle | Akira Kurata Sachio Suzuki Kazuhisa Iwamoto Kuniaki Nakahara Katsutoshi Abe Madoka Inukai June Niki Makoto Sasaki Kiyotaka Fujii Shingo Konno Shinichi Kan Kazuaki Fukasaku Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms Stroke Research and Treatment |
| title | Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms |
| title_full | Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms |
| title_fullStr | Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms |
| title_full_unstemmed | Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms |
| title_short | Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms |
| title_sort | altered hemodynamics associated with pathogenesis of the vertebral artery dissecting aneurysms |
| url | http://dx.doi.org/10.1155/2012/716919 |
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