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中华神经创伤外科电子杂志 ›› 2015, Vol. 01 ›› Issue (06) : 46 -49. doi: 10.3877/cma.j.issn.2095-9141.2015.06.012

所属专题: 文献

专题笔谈

椎基底动脉延长扩张综合征
李婧莲1,()   
  1. 1. 065201 廊坊,河北省燕郊人民医院神经外科
  • 收稿日期:2015-05-11 出版日期:2015-12-15
  • 通信作者: 李婧莲

Vertebrobasilar dolichoectasia

Jinglian Li1,()   

  1. 1. Department of Neurosurgery, Yanjiao People’s Hospital, Langfang 065201, China
  • Received:2015-05-11 Published:2015-12-15
  • Corresponding author: Jinglian Li
  • About author:
    Corresponding author: Li Jinglian, Email:
引用本文:

李婧莲. 椎基底动脉延长扩张综合征[J]. 中华神经创伤外科电子杂志, 2015, 01(06): 46-49.

Jinglian Li. Vertebrobasilar dolichoectasia[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2015, 01(06): 46-49.

椎基底动脉延长扩张综合征(VBD),病变主要累及颅内动脉的中膜层。延长扩张的动脉通常具有异常增粗的直径,但是动脉壁较薄;同时存在血管腔内血栓。主要临床表现包括急性脑缺血,进展性颅神经、脑干或第3脑室压迫以及急性血管破裂造成的灾难性后果。该病相对少见,但临床预后可能极差,为此,笔者对该病的病理学、病理生理过程、临床表现做一综述,以提高广大医务工作者对该病的认识。

Vertebralbasilar dolichoectasia (VBD) is a relatively rare condition affecting mainly the tunica media of the vertebrabasilar arteries with poor prognosis. As is characterized by elongation and distension of arteries, it commonly shows excessively enlarged vessel diameter with weakened vessel walls and is accompanied by, sometimes, thrombus. Patients with VBD may suffer from catastrophic consequences caused by acute cerebral ischemia, acute rupture of the vascular, or progressive compression of the cranial nerves, the brainstem or the third ventricle. In this review, the author gives an overview of the pathology, pathophysiology and clinical manifestation of VBD, in hope to provide clinicians with a better understanding of the disease.

[13]
Mitsias P, Levine SR. Cerebrovascular complications of Fabry’s disease[J]. Ann Neurol, 1996, 40(1): 8-17.
[14]
Steen RG, Langston JW, Ogg RJ, et al. Ectasia of the basilar artery in childrenwith sickle cell disease: relationship to hematocrit and psychometric measures[J]. J Stroke Cerebrovasc Dis, 1998, 7(1): 32-43.
[15]
Rautenberg W, Aulich A, R?ther J, et al. Stroke and dolichoectatic intracranial arteries[J]. Neurol Res, 1992, 14(2 Suppl): 201-203.
[16]
Levine RL, Turski PA, Grist TM. Basilar artery dolichoectasia. Review of the literature and six patients studied with magnetic resonance angiography[J]. J Neuroimaging, 1995, 5(3): 164-170.
[17]
Passero, SG, Rossi S. Natural history of vertebrobasilar dolichoectasia[J]. Neurology, 2008, 70(1): 66-72.
[18]
Ince B, Petty GW, Brown RD Jr, et al. Dolichoectasia of the intracranial arteries in patients with first ischemic stroke: a population-based study[J]. Neurology, 1998, 50(6): 1694-1698.
[19]
Passero S. Filosomi G. Posterior circulation infarcts in patients with vertebrobasilar dolichoectasia[J]. Stroke, 1998, 29(3): 653-659.
[20]
Nakatomi H, Segawa H, Kurata A, et al. Clinicopathological study of intracranial fusiform and dolichoectatic aneurysms: insight on the mechanism of growth[J]. Stroke, 2000, 31(4): 896-900.
[21]
Kumral E, Kisabay A, Atac C, et al. The mechanism of ischemic stroke in patients with dolichoectatic basilar artery[J]. Eur J Neurol, 2005, 12(6): 437-444.
[22]
Graf S, Schischma A, Eberhardt KE, et al. Intracranial aneurysms and dolichoectasia in autosomal dominant polycystic kidney disease[J]. Nephrol Dial Transplant, 2002, 17(5): 819-823.
[23]
Passero SG, Calchetti B, Bartalini S. Intracranial bleeding in patients with vertebrobasilar dolichoectasia[J]. Stroke, 2005, 36(7): 1421-1425.
[24]
Rabb CH, Barnwell SL. Catastrophic subarachnoid hemorrhage resulting from ruptured vertebrobasilar dolichoectasia: case report[J]. Neurosurgery, 1998, 42(2): 379-382.
[25]
Saloheimo P, Juvela S, Hillbom M. Use of aspirin, epistaxis, and untreated hypertension as risk factors for primary intracerebral hemorrhage in middleaged and elderly people[J]. Stroke, 2001, 32(2): 399-404.
[26]
Rahman EA, Trobe JD, Gebarski SS. Hemifacial spasm caused by vertebral artery dolichoectasia[J]. Am J Ophthalmol, 2002, 133(6): 854-856.
[27]
Barker FG 2nd, Jannetta PJ, Bissonette DJ, et al. Microvascular decompression for hemifacial spasm[J]. J. Neurosurg, 1995, 82(2): 201-210.
[28]
Love S, Hilton DA, Coakham HB. Central demyelination of the Vth nerve root in trigeminal neuralgia associated with vascular compression[J]. Brain Pathol, 1998, 8(1): 1-11.
[29]
Goldenberg-Cohen N, Miller NR. Noninvasive neuroimaging of basilar artery dolichoectasia in a patient with an isolated abducens nerve paresis[J]. Am J Ophthalmol, 2004, 137(2): 365-367.
[30]
Savitz SI, Ronthal M, Caplan LR. Vertebral artery compression of the medulla[J]. Arch.Neurol, 2006, 63(2): 234-241.
[31]
Siddiqui A, Chew NS, Miszkiel K. Vertebrobasilar dolichoectasia: a rare cause of obstructive hydrocephalus: case report[J]. Br J Radiol, 2008, 81(964): e123-e126.
[32]
Milandre L, Bonnefoi B, Pestre P, et al. Vertebrobasilar arterial dolichoectasia. Complications and prognosis[J]. Rev Neurol(Paris). 1991, 147(11): 714-722.
[33]
Ubogu EE, Zaidat OO. Vertebrobasilar dolichoectasia diagnosed by magnetic resonance angiography and risk of stroke and death: a cohort study[J]. J Neurol Neurosurg Psychiatry, 2004, 75(1): 22-26.
[34]
郎颖涛,刘占况,崔玉环等.发生脑卒中的椎基底动脉延长扩张症患者临床影像学特征及心血管疾病危险因素[J].实用医学杂志, 2011, 27(16): 2993-2995.
[35]
鹿桂凤,张道培,张杰文等.椎基底动脉延长扩张症的影像学量化评估方法[J].国际脑血管病杂志, 2015, (8): 622-627.
[36]
以脑干压迫症状为表现的椎基底动脉延长扩张症临床和影像学研究[J].中国神经精神疾病杂志, 2009, 35(11): 663-666.
[37]
罗沛霖,洪璇阳,王海林等.椎基底动脉延长扩张症CT灌注成像时间-密度曲线的定量分析[J].实用医学杂志, 2012, 28(18): 3041-3043.
[38]
杨运俊,陈伟建,诸葛启钏等.多层螺旋CT血管成像在椎基底动脉延长扩张症中的诊断价值[J].中华放射学杂志, 2009, 43(1): 50-53.
[39]
韩金涛,乔惠婷,韩旭等.椎基底动脉延长扩张症的计算流体力学分析[J].北京大学学报(医学版), 2015, (2): 302-304.
[1]
Caplan LR. Dilatative arteriopathy(dolichoectasia): What is known and not known[J]. Ann Neurol, 2005, 57(4): 469-471.
[2]
Pico F, Labreuche J, Cohen A, et al. Intracranial arterial dolichoectasia is associated with enlarged descending thoracic aorta[J]. Neurology, 2004, 63(11): 2016-2021.
[3]
Dziewas R, Freund M, Lüdemann P, et al. Treatment options in vertebrobasilar dolichoectasia-case report and review of the literature[J]. Eur Neurol, 2003, 49(4): 245-247.
[40]
袁永杰,罗祺,许侃等.椎基底动脉延长扩张症的研究进展[J].中华神经外科杂志, 2013, 29(2): 210-213.
[4]
Yu YL, Moseley IF, Pullicino P, et al. The clinical picture of ectasia of the intracerebral arteries[J]. J Neurol Neurosurg Psychiatry, 1982, 45(1): 29-36.
[5]
Pico F, Labreuche J, Touboul PJ, et al. Intracranial arterial dolichoectasia and its association with carotid atherosclerosis and stroke subtype[J]. Neurology, 2003, 61(12): 1736-1742.
[6]
Lou M, Caplan LR. Vertebrobasilar dilatative arteriopathy (dolichoectasia)[J]. Ann N Y Acad Sci, 2010, 1184: 121-133.
[7]
Sacks, JG, Lindenburg R. Dolichoectatic intracranial arteries: symptomatology and pathogenesis of arterial elongation and distention[J]. Johns Hopkins Med J, 1969, 125(2): 95-106.
[8]
Gautier, JC, Hauw JJ, Awada A, et al. Dolichoectatic intracranial arteries. Association with aneurysms of the abdominal aorta[J]. Rev Neurol(Paris), 1988, 144(6-7): 437-446.
[9]
Hirsch CS, Roessmann U. Arterial dysplasia with ruptured basilar artery aneurysm: report of a case[J]. Hum Pathol, 1975, 6(6): 749-758.
[10]
Pico F, Biron Y, Bousser MG, et al. Concurrent dolichoectasia of basilar and coronary arteries[J]. Neurology, 2005, 65(9): 1503-1504.
[11]
Silverman IE, Berman DM, Dike GL, et al. Vertebrobasilar dolichoectasia associated with Marfan syndrome[J]. J Stroke Cerebrovasc Dis, 2000, 9(4): 196-198.
[12]
Zambrino CA, Berardinelli A, Martelli A, et al. Dolicho-vertebrobasilar abnormality and migraine-like attacks[J]. Eur Neurol, 1999, 41(1): 10-14.
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