中国卒中杂志 ›› 2016, Vol. 11 ›› Issue (04): 318-323.

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椎动脉发育不良的临床现状研究

张倩,郭阳   

  1. 110004 沈阳中国医科大学附属盛京医院神经内科
  • 收稿日期:2015-10-19 出版日期:2016-04-20 发布日期:2016-04-20
  • 通讯作者: 郭阳 guoy@sj-hospital.org

Clinical Research Status of Vertebral Artery Hypoplasia

  • Received:2015-10-19 Online:2016-04-20 Published:2016-04-20

摘要:

椎动脉发育不良与椎动脉先天闭塞,特别是在椎动脉的解剖变异中,是一种并不常见的 后循环胚胎变异。大量数据表明在伴或不伴有基底动脉形态变异的情况下,尤其在合并了其他脑血管 危险因素时,后循环缺血的发生与椎动脉发育不良有关。尽管在椎动脉发育不良的定义与评估方法上 仍存在争议,既往的研究通过彩色多普勒超声发现同侧的发育不良的椎动脉净流速降低,而发育正 常的椎动脉净流速代偿性的增加,导致局部血流低灌注,甚至出现临床症状,说明椎动脉发育不良 具有更易于闭塞的特点,并增加了远端血栓形成的概率[1]。此外,椎动脉发育不良可能引发其他复杂 的神经血管疾病如偏头痛、前庭神经元炎、发作性眩晕以及椎动脉夹层等。

文章导读: 椎动脉发育不良通过影响血流动力学,与后循环缺血性卒中、偏头痛和前庭神经元炎等相关。

关键词: 椎动脉发育不良; 后循环缺血性卒中; 低灌注; 基底动脉迂曲

Abstract:

As uncommon embryonic variations of posterior circulation, especially the anatomic variations of vertebral artery (VA), vertebral artery hypoplasia (VAH) and vertebral artery aplasia (VAA), with or without basilar artery morphological abnormalities, have been suggested by substantial data of having relationship with posterior circulation ischemic events, particularly in conjunction with other cerebral vascular risk factors. Inspite of disagreement existing in definition and evaluation methods of VAH, color Doppler ultrasonography (CDU) of previous studies have found lower net VA flow volume of ipilateral hypoplasic artery and an increased compensatory flow volume of non-hypoplasic artery, resulting local hypoperfusion, even clinical symptoms, illustrating the characteristics of VAH’s more vulnerable to occlusion and distal thrombosis[1]. Besides, VAH may result in other complex neurovascular consequences such as migraine, vestibular neuronitis (VN), episodic dizziness and vertebral artery dissection (VAD), etc.

Key words: Vertebral artery hypoplasia; Posterior circulation ischemic stroke; Hypoperfusion; Basilar artery tortuous