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Natural history of vertebrobasilar dolichoectasia

From the Department of Neurosciences, Neurology Unit, University of Siena, Italy.

Address correspondence and reprint requests to Dr. S. Passero, Dipartimento di Neuroscienze, Sezione di Neurologia, Università di Siena, Viale Bracci, I-53100 Siena, Italy

Objective: The long-term prognosis of patients with vertebrobasilar dolichoectasia (VBD) is unknown. The purpose of this study was to explore the natural history of VBD, evaluate its progression, and examine factors that may influence the clinical course of this condition.

Methods: We conducted a prospective clinical and imaging follow-up study of 156 consecutive patients with VDB followed for an average of 11.7 years. Predictors of events were evaluated by multivariate analysis. Survival analysis was used to evaluate rates of incidence.

Results: During follow-up, 93 patients (60%) experienced at least one event: 75 patients had stroke (59 ischemic and 21 hemorrhagic), 31 patients had new compressive symptoms, and 2 patients had hydrocephalus. Events were significantly associated with the severity of VBD, i.e., diameter, height of bifurcation, and lateral displacement of the basilar artery. During follow-up VBD progressed in 43% of patients. Progression of VBD was associated with a higher morbidity and mortality. The cumulative proportion of survivors free of adverse health event was 54.1 at 5 years, 39.5 at 10 years, and 23.5 at 15 years. During follow-up, 62 patients died and stroke was the most common cause of death.

Conclusions: The long-term prognosis of patients with vertebrobasilar dolichoectasia (VBD) depended mainly on the severity of the condition at diagnosis and on its evolutionary characteristics. Progression of VBD exposed patients to high risk of adverse events, especially stroke.

GLOSSARY: BA = basilar artery; CAD = coronary artery disease; ICA = intracavernous internal carotid arteries; MCA = middle cerebral arteries; VA = vertebral arteries; VBD = vertebrobasilar dolichoectasia.

passero{at}unisi.it

Disclosure: The authors report no conflicts of interest.

Received January 30, 2007. Accepted in final form June 12, 2007.

This article has been cited by other articles:

				J M Hong, C-S Chung, O Y Bang, S W Yong, I S Joo, and K Huh Vertebral artery dominance contributes to basilar artery curvature and peri-vertebrobasilar junctional infarcts J. Neurol. Neurosurg. Psychiatry, October 1, 2009; 80(10): 1087 - 1092. [Abstract] [Full Text] [PDF]

				S. Sarikaya, B. Sarikaya, and S. G. Passero NATURAL HISTORY OF VERTEBROBASILAR DOLICHOECTASIA Neurology, October 28, 2008; 71(18): 1460 - 1460. [Full Text] [PDF]

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