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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Vertebral artery aneurysms and associated vascularvariants

Aneurysmen der A.vertebralis und assoziierte vaskuläre Normvarianten

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  • presenting/speaker Ali Harati - Klinikum Dortmund, Neurochirurgie, Dortmund, Deutschland
  • Dominik Zeh - Klinikum Dortmund, Neurochirurgie, Dortmund, Deutschland
  • Rolf Schultheiß - Klinikum Dortmund, Neurochirurgie, Dortmund, Deutschland
  • Kirsten Schmieder - Knappschaftskrankenhaus Bochum, Ruhr Universität Bochum, Neurochirurgische Klinik, Bochum, Deutschland
  • Stefan Rohde - Klinikum Dortmund, Neuroradiologie, Dortmund, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV292

doi: 10.3205/19dgnc311, urn:nbn:de:0183-19dgnc3110

Published: May 8, 2019

© 2019 Harati et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The aim of this retrospective case-control study is to determine the association of vertebral artery hypoplasia (VAH) and other anatomical variants with saccular vertebral artery posterior inferior cerebellar artery (VA-PICA) aneurysms.

Methods: The prevalence of VAH, vertebral artery (VA) atresia, fetal distribution, VA, and PICA aplasia have been analyzed by CT angiography in 64 patients with VA-PICA aneurysms (43 ruptured and 21 unruptured) and compared to 128 age- and sex-matched controls. VAH is defined by a diameter of ≤ 2 mm at the level of the foramen magnum. Logistic regression is performed to identify independent risk factors for aneurysm formation.

Results: VAH (53% vs. 17%; odds ratio [OR] 4.8; 95% confidence interval [CI] 2.4–9.4; p<0.0001) and VA aplasia (14% vs. 1%; OR 20.8; 95% CI 2.5–168.0; p=0.004) is observed significantly more often in patients with VA-PICA aneurysms than in controls, using univariate analysis. Multivariate analysis identifies VAH (odds ratio, 3.6; 95% CI 1.8–7.3; p<0.0001), as independent strong risk factor for VA-PICA aneurysm formation. VA-PICA aneurysms is detected significantly more often in the dominant VA, contralateral to VAH. Other anatomical variants are not related to aneurysm formation.

Conclusion: VAH and VA aplasia are potential risk factors for VA-PICA aneurysms. Additional research should clarify the pathophysiological association of VAH, VA aplasia, or vascular occlusion with arteriosclerosis and intracranial aneurysm formation.