1.Hypoplasia of Left Vertebral Artery with Intimal Fibromuscular Dysplasia in a Korean Woman.
Chang Lim HYUN ; Hyun Sik PARK ; Hyun Jo SHIN ; Sang Pil YOON
Journal of Korean Medical Science 2012;27(7):811-813
We found a case of hypoplasia of vertebral artery with fibromuscular dysplasia in an 82-yr-old Korean female cadaver during a routine dissection course. In the present case, intracranial hypoplasia in left vertebral artery and bilateral origin of posterior inferior cerebellar artery at the vertebrobasilar junction were recognized. Histopathologically, left vertebral artery showed intimal type of fibromuscular dysplasia both in its extracranial and intracranial courses. These results indicate that the association of fibromuscular dysplasia and hypoplasia does exist in the vertebral artery, although the etiologies are not verified yet.
Aged, 80 and over
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Female
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Fibromuscular Dysplasia/*pathology
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Heart Ventricles/abnormalities/*pathology
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Humans
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Republic of Korea
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Vertebral Artery/*pathology
2.Effect of cervical spine instability on cervical spondylosis of vertebral artery.
China Journal of Orthopaedics and Traumatology 2009;22(5):352-353
Adult
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Aged
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Female
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Humans
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Male
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Middle Aged
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Spinal Fusion
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methods
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Spine
;
pathology
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Spondylosis
;
pathology
;
physiopathology
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Vertebral Artery
;
pathology
3.The prior occlusion of bilateral vertebral arteries during producing global cerebral ischemic damage model may play a protective role as preconditioning.
Jin-Xia GENG ; Min ZHANG ; Wen-Bin LI ; Li-Hua GUO ; Qing-Jun LI ; Xiao-Hui XIAN
Chinese Journal of Applied Physiology 2007;23(1):24-29
AIMTo study the effect of different intervals between occlusions of vertebral arteries and bilateral common carotid arteries on the Pulsinelli 4-vessel occlusion global cerebral ischemic model, and the features of ischemia of the brainstem and hippocampus induced by occulusion of bilateral common carotid arteries under the condition of occlusion of unilateral vertebral artery.
METHODSEighty four adult male Wistar rats were divided into 4 groups randomly: control group, bilateral vertebral artery occluding group, global brain ischemic insult group, and unilateral vertebral artery occluding plus bilateral common carotid arteries occluding group. In the global brain ischemic insult group, rats were further divided into 24 h, 48 h, and 72 h interval subgroups according to the interval between the occlusion of the vertebral arteries and bilateral common carotid arteries. The responses including enlarging of pupils and the light reflex during the brain ischemia were observed. The duration of right reflex disappearing, the general state, and the delayed neuronal death (DND) of pyramidal neurons in the CA1 hippocampus of the rats after the brain ischemia were also observed.
RESULTSAmong the global brain ischemic insult group, both the responses and DND were more severe in 72 h interval subgroup than those in 24 h and 48 h interval subgroups. There was no significant difference between 24 h and 48 h interval subgroups. When the bilateral common carotid arteries were occluded under the condition of occlusion of unilateral vertebral artery, severe DND was observed in the CA1 hippocampus ipsilateral to the occluding vertebral artery, but no significant DND was observed in the contralateral CA1 hippocampus.
CONCLUSIONThe results suggested that the prior occlusion of the bilateral vertebral arteries during producing Pulsinelli 4-vessel occlusion global cerebral ischemic model might be a cerebral ischemic preconditioning that could protect to some extent pyramidal neurons of the hippocampus against severe ischemic insult induced by occlusion of bilateral common carotid arteries within 48 h. Moreover, There is ipsilateral predominance of blood perfusion from one side of vertebral artery to the brainstem and hippocampus, although there was Willis artery circle in rats.
Animals ; Brain Ischemia ; prevention & control ; Hippocampus ; blood supply ; Ischemic Preconditioning ; methods ; Male ; Rats ; Rats, Wistar ; Vertebral Artery ; pathology
4.Extracranial vertebral arteriovenous fistula presenting as an osteolytic lesion of the axis: Case report.
Sang Hoon SHIN ; Chun Kee CHUNG ; Hyun Jib KIM ; Moon Hee HAN ; Dae Hee HAN
Journal of Korean Medical Science 1996;11(6):532-536
Arteriovenous fistulas of the extracranial vertebral artery are rare. The authors report a case of a spontaneous arteriovenous fistula of the extracranial vertebral artery presenting as an osteolytic lesion at the body of the axis. The patient presented with headache and posterior neck pain. The fistula was obliterated by an endovascular trapping.
Adult
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Arteriovenous Fistula/*pathology/surgery
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Axis/*pathology
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Case Report
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Follow-Up Studies
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Human
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Male
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Osteolysis/pathology
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Support, Non-U.S. Gov't
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Vertebral Artery/*pathology/surgery
6.A Case of Pseudo-Vestibular Neuritis with Contralesional Canal Paresis due to Spontaneous Bilateral Vertebral Artery Dissection.
Dae Bo SHIM ; Mee Hyun SONG ; Kye Chun PARK ; Chang Eun SONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2014;57(8):552-555
Pseudo-vestibular neuritis is a central pathology of acute vestibular syndrome, characterized by unidirectional nystagmus mimicking acute peripheral vestibulophaty. We report a 39-year-old female patient who developed cerebellar infarction with isolated vertigo, spontaneous nystagmus, a positive head thrust test, and unilateral canal paresis in the contralesional side. The patient had no vascular risk factors. A diffusion-weighted image of the brain showed infarction of medial branch of posterior inferior and superior cerebellar artery on the left side. A magnetic resonance angiography of neck disclosed a wide range of diffused severe stenosis and narrowing of right and left vertebral arteries, respectively. This case suggests the possibility of vestibular ischemia masking the central pathology in isolated vertigo.
Adult
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Arteries
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Brain
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Constriction, Pathologic
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Embolism
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Female
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Head Impulse Test
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Humans
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Infarction
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Ischemia
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Magnetic Resonance Angiography
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Masks
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Neck
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Neuritis*
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Nystagmus, Pathologic
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Paresis*
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Pathology
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Risk Factors
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Vertebral Artery
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Vertebral Artery Dissection*
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Vertigo
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Vestibular Neuronitis
7.Therapeutic effect of far lateral approach on the lesions located ventral to cranial-cervical junction.
Bo WU ; Chao YOU ; Bo-wen CAI ; Min HE ; Ke-gang SHUAI
Chinese Journal of Surgery 2005;43(9):612-615
OBJECTIVETo investigate the administration of far-lateral approach in lesions located anterior or anterolateral to brain stem and upper cervical spinal cord.
METHODSTwenty-three patients underwent far lateral approach, including 12 retrocondylar approach, 5 partial transcondylar approach, 3 transfacetal and partial transcondylar approach, 2 transtubercular approach and 1 complete transcondylar approach.
RESULTSTotal tumor removal was achieved in 15 patients, subtotal removal in 5 patients, 3 vertibral artery aneurysms were clipped successfully, 3 patients were given occipitalcervical fusion. There was no operative mortality. The most frequent complications were lower cranial nerve deficit, CSF leakage, injury to vertibral artery, and ischemia of brain stem, cerebellum or spinal cord. No patient presented clinical instability of the occipitocervical junction after surgery.
CONCLUSIONSThe far-lateral approach is an ideal approach to structures located ventral to cranial-cervicle junction. But some of the surgical steps are technically difficult and carry some degree of risk. The choice of approach depends on the pathological feature and degree of exposure required for effective surgical treatment. Bone removal should be quantified for individual lesion. The approach may be limited to less aggressive steps, while still achieving significant exposure and surgical space.
Adolescent ; Adult ; Aneurysm ; surgery ; Basilar Artery ; surgery ; Brain Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Treatment Outcome ; Vertebral Artery ; surgery
8.Surgical Treatment of Vertebrobasilar Insufficiency
Geun Eun KIM ; Ho Sung KIM ; Tae Won KWON ; Yong Pil CHO
Journal of the Korean Society for Vascular Surgery 1998;14(2):261-264
Vertebral artery reconstructions are less frequently performed in Korea and diagnosis of vertebrobasilar insufficiency is often missed due to complexity of the symptoms. Authors report 15 vertebral artery reconstructions from September 1995 through December 1997: 5 saphenous vein patch angioplasty, 3 axillary-axillary artery bypass, 2 bovine patch angioplasty, 2 subclavian-vertebral artery bypass, 1 thyrocervical trunk-vertebral artery bypass, 1 carotid-vertebral artery bypass, 1 angioplasty of left vertebral artery & concomitant left subclavian-right axillary artery bypass following by percutaneous transluminal stented angioplasty of innominate artery. Majority of pathology were arteriosclerosis (13 patients) with stenosis at subclavian-vertebral artery junction and Takayasu's arteritis were next (2 patients). Postoperative result was satisfactory and symptoms of dysarthria, ataxic gate, dizziness or vertigo were relieved in all patients. With proper surgical treatment, symptomatic improvement and prevention of cerebral ischemia in vertebrobasilar insufficiency can be achieved.
Angioplasty
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Arteries
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Arteriosclerosis
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Axillary Artery
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Brachiocephalic Trunk
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Brain Ischemia
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Constriction, Pathologic
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Diagnosis
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Dizziness
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Dysarthria
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Humans
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Korea
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Pathology
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Saphenous Vein
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Stents
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Takayasu Arteritis
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Vertebral Artery
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Vertebrobasilar Insufficiency
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Vertigo
9.Pathomorphological change of the atlanto-occipital segment of vertebral artery related with cervical vertigo.
Bing-hua FAN ; Li XU ; Min LIN ; Wei LI ; Fang-jun WANG ; Quan-zhen XU
China Journal of Orthopaedics and Traumatology 2015;28(1):39-42
OBJECTIVETo explore the pathomorphological change of the atlanto-occipital segment of vertebral artery (V3 part) related with cervical vertigo.
METHODSFrom June 1999 to November 2011, the pathomorphological change of the atlanto-occipital segment of vertebral artery were observed in 1680 patients with cervical vertigo using 3D-CTA technology. The clinical data of these patients were analyzed. There were 783 males and 897 females, aged from 22 to 70 years old with an average of 52.8 years old. Doppler examination showed vertebral basilar artery flow velocity to speed up or slow down.
RESULTSThe blood vessel of 3360 branches were detected in 1680 patients and 2778 branches were detected out vascular anomaly. And 829 branches were in V1 segment, 421 were in V2, 328 were in V3, 1190 were in V4. The pathomorphological changes in the atlanto-occipital segment (V3) of vertebral artery included angiospasm, congenital absence, abnormal exit, localized stenosis.
CONCLUSIONThere are 4 kinds of pathomorphological changes in the atlanto-occipital segment of vertebral artery related with cervical vertigo. The 3D-CTA result can be used to judge prognosis and adopt reasonable treatment for the patients.
Adult ; Aged ; Atlanto-Occipital Joint ; Cervical Vertebrae ; Female ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Vertebral Artery ; diagnostic imaging ; pathology ; Vertigo ; pathology
10.Wall Imaging for Unilateral Intracranial Vertebral Artery Hypoplasia with Three-dimensional High-isotropic Resolution Magnetic Resonance Images.
Xian-Jin ZHU ; Wu WANG ; Bin DU ; Lei LIU ; Xin-Xin HE ; Li-Bin HU ; Xue-Bin ZHANG ; Zun-Jing LIU ; Wei-Jian JIANG
Chinese Medical Journal 2015;128(12):1601-1606
BACKGROUNDThere are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia (VAH). The aim of this study was to determine wall characteristics of VAH with three-dimensional volumetric isotropic turbo spin echo acquisition (3D VISTA) images and differentiate between acquired atherosclerotic stenosis and VAH.
METHODSThirty patients with suspicious VAH by luminograms were retrospectively enrolled between January 2014 and February 2015. The patients were classified as "acquired atherosclerotic stenosis" or "VAH" based on 3D VISTA images. The wall characteristics of VAH were assessed to determine the presence of atherosclerotic lesions, and the patients were classified into two subgroups (VAH with atherosclerosis and VAH with normal wall). Wall characteristics of basilar arteries and vertebral arteries were also assessed. The clinical and wall characteristics were compared between the two groups.
RESULTSFive of 30 patients with suspicious VAH were finally diagnosed as acquired atherosclerotic stenosis by 3D VISTA images. 25 patients were finally diagnosed as VAH including 16 (64.00%) patients with atherosclerosis and 9 (36.00%) patients with normal wall. In the 16 patients with atherosclerosis, plaque was found in 9 patients, slight wall thickening in 6 patients, and thrombus and wall thickening in 1 patient. Compared with VAH patients with normal wall, VAH patients with atherosclerosis showed atherosclerotic basilar arteries and dominant vertebral arteries more frequently (P = 0.000).
CONCLUSIONSThree-dimensional VISTA images enable differentiation between the acquired atherosclerotic stenosis and VAH. VAH was also prone to atherosclerotic processes.
Aged ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Plaque, Atherosclerotic ; pathology ; Retrospective Studies ; Vertebral Artery ; abnormalities ; pathology