Dolichoectasia in vertebrobasilar arteries presented as transient ischemic attacks: A case report.
BACKGROUND
Vertebrobasilar dolichoectasia (VBD) is a rare vasculopathy. The etiology of this disease is unknown. Transient ischemic attacks (TIAs) of vertebrobasilar system refer to a transient (< 24 hours) lowering of blood flow in the posterior circulation of the brain. We present a case of dolichoectasia in the vertebrobasilar artery that presented with TIAs.


METHODS
A hypertensive 54-year-old man with true vertigo, nausea, imbalance, dysarthria, dysmetria, horizontal nystagmus, and gait ataxia was referred to Alzahra Hospital, Isfahan, Iran. The symptoms improved in the 1st day, but recurred in the 2nd day, lasting for 6-7 hours. According to clinical manifestations, a diagnosis of TIAs in the vertebrobasilar circulation was made. Imaging studies showed vascular anomaly. The vascular anomaly was considered as the cause of the patient's symptoms. A medical management was started using antiplatelet and antihypertensive drugs. The patient was referred for a more evaluation for other vascular anomalies.


CONCLUSIONS
Dolichoectasia usually affects vertebral and basilar arteries and simultaneous involvement of carotid arteries is rare seen in only 0.5% of these patients. The usual symptom of dolichoectasia is ischemia and rarely hemorrhages. The most common type of ischemic stroke is lacunar type. Ischemia evolves from embolic that originate from thrombi or plaques in the walls of the ectatic artery. While hemodynamic effects are the most common cause of the presenting signs and symptoms of the anomaly. We report a case of dolichoectasia that presented with TIAs of the verterbrobasilar artery. VBD is a distinct arteriopathy known as stroke risk.
Professor, Isfahan Neurosciences Research Center AND Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Reza
MR
Najafi
Resident, Isfahan Neurosciences Research Center AND Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Nafiseh
N
Toghianifar
Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Morteza
M
Abdar Esfahani
Student of Medicine, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Amin
MA
Najafi
General Practitioner, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Javad
MJ
Mollakouchakian
Transient Ischemic Attacks; Vasculopathy; Vertebrobasilar Dolichoectasia