The Related Research Between Vertebral Artery Hypoplasia(VAH) And Posterior Circulation Infarction(PCI)

Objective:Posterior circulation ischemia is a common ischemic cerebrovascular disease.Vertebral artery is an important part of the posterior circulation.Vertebral artery hypoplasia(VAH) is a common type of vertebral artery variations. Studies have shown that VAH is a induction factor for posterior circulation infarction, especially in the case of other cerebrovascular disease risk factors exist.The purpose of this article is to explore the relation between VAH and posterior circulation infarction its possible mechanism.Methods:Sixty-six patients with cerebral infarction who were hospitalized in Department of Neurology of Fu Jian Union Hospital from January 2014 to June 2015 were successively recruited.All of them were taken a blood test on an empty stomach in the next 24 hours.All patients were examined using cranial magnetic resonance imaging(MRI) and underwent color Doppler ultrasonography for the neck section of the vertebral artery after admission.The patients were divided into two groups according to the location of the infarct lesions as cranial MRI shows : anterior circulation infartion group and posterior circulation infarction group,642 anterior circulation strokes and 287 posterior circulation strokes. And then further divide the posterior circulation infarction patients into four groups:VAH on the left side group,VAH on the right side group,VAH on the both side group,non-VAH on the both side group. The number of these four groups is 17,25,1,244 in sequence.Clinical baseline data, Biochemical index(including high density lipoprotein Cholesterol LDL-C,Low Density Lipoprotein Cholesterol HDL-C),the index color Doppler ultrasonography for the neck section of the vertebral artery shows like vertebral artery diameter(VAD), resistance index(RI), peak systolic velocity peak systolic velocity(PSV), end diastolic velocity( EDV), mean flow rate(MF).According to diagnostic criteria of VAH,calculating the incidence of VAH on anterior circulation infarction and posterior circulation infarction.Observingthe relation between the side PCI distributes and the side VAH distributes,using x2 test to compare and analyze.Results:1.In patients with cerebral infarction, the incidence of VAH on the right side(55.6%) is greater than VAH on the left side(44.4%).Among patients with cerebral infarction, VAH shows a male dominance(56.6%). 2.Differences between ACI patients and PCI ones in cerebrovascular disease risk factors such as age, sex, hypertension, diabetes, hyperlipidemia, smoking, drinking are no statistical significance, VAH was more frequentin posterior circulation than in anterior circulation. 3. In 43 PCI patients with VAH, whether VAH is located on the left side, or on the right side, the number of cases that VAH and the posterior circulation infarction are located on the same side is a total of 27(62.80%). 4. PCI patients with left VAH, comparied the normal side with affected side, VAD(p = 0.001), EDV(p = 0.0006), MF(p = 0.002), RI(p = 0.019) have significant statistical differences, the PSV has no statistically significant difference(p = 0.052).PCI patients with right VAH, comparied the normal side with affected side, VAD(p = 0.001),EDV(p = 0.047), MF(p = 0.008), RI(p = 0.01) have significant statistical differences, PSV has no statistically significant difference(p = 0.554).PCI patients with non VAH bilateral, comparied with bilateral vertebral artery, VAD(p = 0.212), PSV(p = 0.851), EDV(p = 0.363), MF(values(p = 0.304), RI(p = 0.319) had no significant statistical differences.Conclusion:In patients with cerebral infarction, the incidence of VAH on the right side is greater than that on the left side, and VAH shows a male dominance.VAH is one of the risk factors promoting stroke in the posterior circulation, posterior circulation infarction and VAH are more common located on the same side than on the contralateral side.The mechanism of VAH poromoting ipsilateral PCI is associated with the decreased vertebral artery diameter, which cause the increased ipsilateral vertebral artery RI and the ruduced blood flow.