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Case Report

The Dilemma of Treating Vertebrobasilar Dolichoectasia

by
Yu-Wei Lin
1,*,
Chih-Hung Chen
2,3 and
Ming-Liang Lai
2,3
1
Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan
2
Stroke Center and Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
3
College of Medicine, National Cheng Kung University, Tainan, Taiwan
*
Author to whom correspondence should be addressed.
Clin. Pract. 2012, 2(4), e84; https://doi.org/10.4081/cp.2012.e84
Submission received: 25 November 2011 / Revised: 2 July 2012 / Accepted: 30 August 2012 / Published: 17 October 2012

Abstract

Vertebrobasilar dolichoectasia (VBD) is a common phenomenon among people over 50 years old, and the related clinical expressions are varied. One of our VBD patients presented with brainstem infarction initially, received low molecular weight heparin treatment, and developed rupture of the dolichoectasia segment. Another patient with a similar-sized VBD experienced recurrent brainstem infarction three times over 2 years, despite higher bleeding tendency and long-term antiplatelet treatment. The third patient with a smallersized VBD, had left hemiplegia and received intravenous recombinant tissue plasminogen activator within 3 h, totally recovered with no lesions detected on brain Magnetic Resonance Imaging (MRI). The pathophysiology of VBD is unique, its prevalence and risks of ischemic stroke and intracranial hemorrhage both increase as the degree of arterial dolichoectasia extends, making the strategy of management quite a challenge. The best management of VBD is controlling arterial hypertension and following up with image studies regularly to detect the early extension of VBD degree.
Keywords: vertebrobasilar dolichoectasia; nonsaccular intracranial aneurysm; ischemic stroke; basilar artery occlusion; subarachnoid hemorrhage vertebrobasilar dolichoectasia; nonsaccular intracranial aneurysm; ischemic stroke; basilar artery occlusion; subarachnoid hemorrhage

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MDPI and ACS Style

Lin, Y.-W.; Chen, C.-H.; Lai, M.-L. The Dilemma of Treating Vertebrobasilar Dolichoectasia. Clin. Pract. 2012, 2, e84. https://doi.org/10.4081/cp.2012.e84

AMA Style

Lin Y-W, Chen C-H, Lai M-L. The Dilemma of Treating Vertebrobasilar Dolichoectasia. Clinics and Practice. 2012; 2(4):e84. https://doi.org/10.4081/cp.2012.e84

Chicago/Turabian Style

Lin, Yu-Wei, Chih-Hung Chen, and Ming-Liang Lai. 2012. "The Dilemma of Treating Vertebrobasilar Dolichoectasia" Clinics and Practice 2, no. 4: e84. https://doi.org/10.4081/cp.2012.e84

APA Style

Lin, Y. -W., Chen, C. -H., & Lai, M. -L. (2012). The Dilemma of Treating Vertebrobasilar Dolichoectasia. Clinics and Practice, 2(4), e84. https://doi.org/10.4081/cp.2012.e84

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