title: Basilar artery angulation in association with aging and pontine lacunar infarction: a multicenter observational study.
abstract: OBJECTIVE
  Deep pontine lacunar infarction (DPLI) not involving the basal pial surface of the medial part of the pons, is known to be a small vessel disease in the territory of the basilar artery (BA). In the present study, we examined whether morphological features of the BA differ in individuals with an advanced age and may be associated with DPLI.
  
  
  METHODS
  This study included 338 healthy subjects and 78 patients with DPLI treated at the stroke centers of three university hospitals in Korea. Time-Of-Flight magnetic resonance angiographic images were transported to a central lab and analyzed blind to obtain the clinical data. For the quantitative analysis, the BA was projected two-dimensionally in the anteroposterior and lateral views and perceived as triangles of the vertebrobasilar junction, angulation point and BA division. The angles and triangular areas were summated into angulation indexes and used to quantify the degree of BA tortuosity.
  
  
  RESULTS
  The BA showed a more acute angle at the angulation point in the elderly patients than in the healthy subjects. Compared to the healthy subjects, the DPLI patients exhibited significantly larger angles at the vertebrobasilar junction, in addition to the acute angles noted at the angulation point. A unit increase in the BA angle indexes at the vertebrobasilar junction and angulation points for DPLI was found to have an odds ratio of 1.15 (95% confidence interval, 1.05-1.26) and 0.95 (95% CI, 0.91-0.99), respectively, even after adjusting for potential confounders.
  
  
  CONCLUSIONS
  The angulation point of the BA becomes more acute in elderly individuals. In this study, the vertebrobasilar junction showed a larger angle in the patients with DPLI than in the healthy controls.
authors.affiliation: Department of Neurology & Research Institute of Clinical Medicine, Chonbuk National University - Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea.
authors.forename: Seul-Ki
authors.initials: SK
authors.lastname: Jeong
authors.forename: Ju-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Do-Hyun
authors.initials: DH
authors.lastname: Nam
authors.forename: Joon-Tae
authors.initials: JT
authors.lastname: Kim
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Ha
authors.forename: Sun-Young
authors.initials: SY
authors.lastname: Oh
authors.forename: Se-Hyoung
authors.initials: SH
authors.lastname: Park
authors.forename: Sang Hyuk
authors.initials: SH
authors.lastname: Lee
authors.forename: Nahmkeon
authors.initials: N
authors.lastname: Hur
authors.forename: Hyo-Sung
authors.initials: HS
authors.lastname: Kwak
authors.forename: Gyung-Ho
authors.initials: GH
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D000465:Algorithms; D001488:Basilar Artery / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011149:Pons / Q000503:physiopathology*; D020521:Stroke / Q000503:physiopathology*; D055815:Young Adult