title: Lateral medullary ischaemic events in young adults with hypoplastic vertebral artery.
abstract: OBJECTIVE
  To present three cases of young adults with lateral medullary ischaemic events associated with a hypoplastic vertebral artery (VA). All three patients had two additional atherosclerotic or non-atherosclerotic risk factors for stroke.
  
  
  METHODS
  One female, aged 40 years, and two males, aged 38 and 37 years, each with two risk factors for stroke, presented to the emergency department with acute onset of symptoms and findings consistent with lateral medullary syndrome. All three patients underwent emergency CT scan of the brain followed by MRI and magnetic resonance angiography (MRA).
  
  
  RESULTS
  The CT scans were negative in all patients. MRI revealed a lateral medullary lesion in only one patient. All three patients had a hypoplastic VA ipsilateral to the clinical ischaemic event on MRA.
  
  
  CONCLUSIONS
  Hypoplasia of VA is not considered a risk factor for stroke as it is a common variant in up to 75% of the general population. However, in our patients, hypoplastic VA coexisted with two risk factors and resulted in stroke. Thus although a hypoplastic VA may not be an uncommon asymptomatic finding, it may contribute to stroke if additional risk factors are present.
authors: Department of Neurology, University of Ioannina School of Medicine, University Campus 45110, Ioannina, Greece. sgiannop@uoi.gr
authors: Sotirios
authors: S
authors: Giannopoulos
authors: Sofia
authors: S
authors: Markoula
authors: Maria
authors: M
authors: Kosmidou
authors: Sygliti-Henrietta
authors: SH
authors: Pelidou
authors: Athanassios P
authors: AP
authors: Kyritsis
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D014854:Lateral Medullary Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D012307:Risk Factors; D014711:Vertebral Artery / Q000002:abnormalities*
references: Eur Neurol. 2006;55(4):193-7
references: 16772715
references: Neurology. 1999 Mar 23;52(5):980-3
references: 10102416
references: J Comput Assist Tomogr. 2002 May-Jun;26(3):462-70
references: 12016382
references: CNS Drugs. 2005;19(8):683-92
references: 16097850
references: Stroke. 1990 Aug;21(8):1222-5
references: 2202095
references: QJM. 2003 Jan;96(1):27-54
references: 12509646
references: Stroke. 2004 May;35(5):1068-72
references: 15060317
references: Stroke. 1986 Sep-Oct;17(5):921-3
references: 3764964
references: Ultrasound Med Biol. 2004 May;30(5):605-9
references: 15183225
references: Eur Radiol. 2005 Jul;15(7):1329-43
references: 15968519
references: Stroke. 1999 Dec;30(12):2692-6
references: 10582999