Ectasia da artéria basilar e acidente vascular cerebral: estudo por imagem em 21 casos

Oliveira, Roberto de Magalhães Carneiro de; Cardeal, José Osmar; Lima, José Geraldo de Camargo

doi:10.1590/S0004-282X1997000400008

Resumos

A ectasia da artéria basilar (EB) pode estar envolvida em diferentes formas de manifestações clínicas, sendo fundamental para seu diagnóstico a análise por métodos de imagem. Procuramos analisar os aspectos de diagnóstico de imagem em 21 pacientes com acidente vascular cerebral e ectasia da artéria basilar. Em todos os pacientes o diagnóstico da EB pôde ser feito pela tomografia computadorizada de crânio. Contudo a ressonânica magnética de crânio mostrou-se o exame de diagnóstico por imagem mais completo para a avaliação das relações entre a EB e as estruturas adjacentes.

acidente vascular cerebral; ectasia; artéria basilar

Ectasia of the basilar artery (EB) may cause different clinical manifestations, and its analysis by imaging methods is fundamental. We tried to analyse radiological aspects in 21 patients with stroke and EB. In all of them, diagnosis could be done by computed tomography. However, magnetic resonance was the most complete diagnostic method for the evaluation of the relantionship between EB an surrounding structures.

cerebrovascular disorder; ectasia; basilar artery

Ectasia da artéria basilar e acidente vascular cerebral: estudo por imagem em 21 casos

Basilar ectasia and stroke: imaging aspects in 21 cases

Roberto de Magalhães Carneiro de Oliveira^I; José Osmar Cardeal^II; José Geraldo de Camargo Lima^III

^IDisciplina de Neurologia da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina; Pós graduando

^IIDisciplina de Neurologia da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina; Professor Adjunto

^IIIDisciplina de Neurologia da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina; Professor Titular (aposentado)

RESUMO

A ectasia da artéria basilar (EB) pode estar envolvida em diferentes formas de manifestações clínicas, sendo fundamental para seu diagnóstico a análise por métodos de imagem. Procuramos analisar os aspectos de diagnóstico de imagem em 21 pacientes com acidente vascular cerebral e ectasia da artéria basilar. Em todos os pacientes o diagnóstico da EB pôde ser feito pela tomografia computadorizada de crânio. Contudo a ressonânica magnética de crânio mostrou-se o exame de diagnóstico por imagem mais completo para a avaliação das relações entre a EB e as estruturas adjacentes.

Palavras-chave: acidente vascular cerebral, ectasia, artéria basilar.

ABSTRACT

Ectasia of the basilar artery (EB) may cause different clinical manifestations, and its analysis by imaging methods is fundamental. We tried to analyse radiological aspects in 21 patients with stroke and EB. In all of them, diagnosis could be done by computed tomography. However, magnetic resonance was the most complete diagnostic method for the evaluation of the relantionship between EB an surrounding structures.

Keywords: cerebrovascular disorder, ectasia, basilar artery.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Agradecimentos - Ao Prof. Dr. José Guilherme M. P. Caldas, a revisão de todos os exames de imagem; aos Professores Dr. Neil Ferreira Novo e Dra. Yara Juliano, a orientação e análise estátisca.

Aceite: 5-maio-1997.

Dr. Roberto de Magalhães Carneiro de Oliveira - Disciplina de Neurologia, Escola Paulista de Medicina - Rua Botucatu 762 - 04023-900 São Paulo SP - Brasil.

1. Biller J, Yuh WTC, Mitchell GW, Bruno A, Adams HP Jr. Early diagnosis of basilar artery occlusion using magnetic resonance imaging. Stroke 1988;19:297-306.
2. Bollensen E, Buzanoski JH, Prange HW. Brainstem compression by basilar artery anomalies as visualized by MRI. J Neurol 1991;238:49-50.
3. Brichaux JC, Gense D, Greselle JF, Jasek F, Bouin H, Caillé J M. Problèmes radiocliniques posés par les méga-dolicho trones basilaires: à propôs de 17 observations et revue de la littérature. J Neuroradiol 1989;16:11-24.
4. Casas Parera I, Gatto M, Asconape J, Vila J, Nogues M, Fernandez Pardal MM, Micheli F. Ectasia da Ias artérias intracraneales. Rev Neurol Arg 1987;13:79-91.
5. Corkill G, Sarwar M, Vigapongse C. Evolution of dolichoectasia of the vertebrobasilar system as evidenced by serial computed tomography. Surg Neurol 1982;18:262-266.
6. Gautier JC, Hauw JJ, Awada A, Loron P, Gray F, Juillard JB. Artères cérébrales dolichoectasiques: association aux anévrysmes de l'aorte abdominale. Rev Neurol (Paris)1988;144:437- 446.
7. Graff-Radford NR, Adams HP Jr, Smoker WRK, Biller J, Boarinni DJ. Unrupted fusiform aneurysms of the posterior circulation with thalamic infarction. Neurosurgery 1985;17:495-499.
8. Greitz T, Lofstedt S. The relationship between the third ventricle and the basilar artery. Acta Radiol 1954;42:85-100.
9. Hatano S. Experience from a multicenter stroke register: a preliminary report. Bull World Health Organ 1976;54:541-553.
10. Hegedus K. Ectasia of the basilar artery with special reference to possible pathogenesis. Surg Neurol 1985;24:463-469.
11. Herpers M, Lodder J, Janevski B, Van Der Lugt PJM. The symptomatology of the megadolicho basilar artery. Clin Neurol Neurosurg 1983;85:203-212.
12. Hultén-Gyllensten IL, Lofstedt S V, Reis G. Observations on generalized arteriectasis. Acta Med Scand 1959; 163:125-130.
13. Kitanaka C, Tanaka J, Kuwahara M, Teraoka A. Magnetic resonance imaging study of intracranial vertebrobasilar artery dissections. Stroke 1994;25:571-575.
14. Milandre L, Martini P, Perot S, Mercier C. Pure motor hemiparesis in a case of vertebrobasilar arterial ectasia. Neuroradiology 1993;35:196-198.
15. Mizutani T, Aruga T. Dolichoectatic intracranial vertebrobasilar dissecting aneurysm. Neurosurgery 1992;31:765-773.
16. Moseley IF, Holland IM. Ectasia of the basilar artery: the breadth of the clinical spectrum and the diagnostic value of computed tomography. Neuroradiology 1979; 18: 83-91.
17. Naseem M, Leehey P, Russell E, Sarwar M, Devasthali R. MR of basilar artery dolichoectasia. AJNR 1988;9:391-392.
18. Nijensohn DE, Saez RJ, Reagan TJ. Clinical significance of basilar artery aneurysms. Neurology 1974;24:301-305.
19. Nishizaki T, Tamaki N, Takeda N, Shirakuni T, Kondoh T, Matsumoto S. Dolichoectatic basilar artery: a review of 23 cases. Stroke 1986;17:1277-1281.
20. Peterson NT, Duchesneau PM, Westbrook EL, Weinstein MA. Basilar artery ectasia demonstrated by computed tomography. Radiology 1977; 122: 713-715.
21. Sacks JG, Lindenberg R. Symptomatology and pathology of arterial elongation and distention. Hopkins Med J 1969;125:95-106.
22. Schwaighofer BW, Klein MV, Lyden PD, Hesselink JR. MR imaging of vertebrobasilar vascular disease. J Comput Assist Tomogr 1990;14:895-904.
23. Scotti G, De Grandi C, Colombo A. Ectasia of the intracranial arteries diagnosed by computed tomography: megadolichobasilar artery CT diagnosis. Neuroradiology 1978;15:183-184.
24. Smoker WR, Price MJ, Keyes WD, Corbett JJ, Gentry LR. High-resolution computed tomography of the basilar artery: 1. Normal size and position. AJNR 1986;7:55-60.
25. Smoker WR, Corbett JJ, Gentry LR, Keyes WD, Price MJ, McKusker S. High-resolution computed tomography of the basilar artery: 2. Vertebrobasilar dolichoectasia: clinical-pathologic correlation and review. AJNR 1986;7:61-72.
26. Waga S, Morikawa A, Kojima T. Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery. Surg Neurol 1979;11:13-16.
27. Wallace S, Jaffe ME. Cerebral arterial ectasia with saccular aneurysms. Radiology 1967;88:90-93.
28. Watanabe T, Sato K, Yoshimoto T. Basilar artery occlusion caused by thrombosis of atherosclerotic fusiform aneurysm of the basilar artery. Stroke 1994;25:1068-1070.
29. Whisnant J P, Bacford JR, Bernstein EF, et al. Classification of cerebrovascular disease III. Stroke 1990-,21:637-676.
30. Yu Y, Moseley I, Pullicino P, McDonald W. The clinical picture of ectasia of the intracerebral arteries. J Neurol Neurosurg Psychiatry 1982;45:29-36.

Datas de Publicação

Publicação nesta coleção
18 Out 2010
Data do Fascículo
Set 1997

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Biller J, Yuh WTC, Mitchell GW, Bruno A, Adams HP Jr. Early diagnosis of basilar artery occlusion using magnetic resonance imaging. Stroke 1988;19:297-306.

[2] 2. Bollensen E, Buzanoski JH, Prange HW. Brainstem compression by basilar artery anomalies as visualized by MRI. J Neurol 1991;238:49-50.

[3] 3. Brichaux JC, Gense D, Greselle JF, Jasek F, Bouin H, Caillé J M. Problèmes radiocliniques posés par les méga-dolicho trones basilaires: à propôs de 17 observations et revue de la littérature. J Neuroradiol 1989;16:11-24.

[4] 4. Casas Parera I, Gatto M, Asconape J, Vila J, Nogues M, Fernandez Pardal MM, Micheli F. Ectasia da Ias artérias intracraneales. Rev Neurol Arg 1987;13:79-91.

[5] 5. Corkill G, Sarwar M, Vigapongse C. Evolution of dolichoectasia of the vertebrobasilar system as evidenced by serial computed tomography. Surg Neurol 1982;18:262-266.

[6] 6. Gautier JC, Hauw JJ, Awada A, Loron P, Gray F, Juillard JB. Artères cérébrales dolichoectasiques: association aux anévrysmes de l'aorte abdominale. Rev Neurol (Paris)1988;144:437- 446.

[7] 7. Graff-Radford NR, Adams HP Jr, Smoker WRK, Biller J, Boarinni DJ. Unrupted fusiform aneurysms of the posterior circulation with thalamic infarction. Neurosurgery 1985;17:495-499.

[8] 8. Greitz T, Lofstedt S. The relationship between the third ventricle and the basilar artery. Acta Radiol 1954;42:85-100.

[9] 9. Hatano S. Experience from a multicenter stroke register: a preliminary report. Bull World Health Organ 1976;54:541-553.

[10] 10. Hegedus K. Ectasia of the basilar artery with special reference to possible pathogenesis. Surg Neurol 1985;24:463-469.

[11] 11. Herpers M, Lodder J, Janevski B, Van Der Lugt PJM. The symptomatology of the megadolicho basilar artery. Clin Neurol Neurosurg 1983;85:203-212.

[12] 12. Hultén-Gyllensten IL, Lofstedt S V, Reis G. Observations on generalized arteriectasis. Acta Med Scand 1959; 163:125-130.

[13] 13. Kitanaka C, Tanaka J, Kuwahara M, Teraoka A. Magnetic resonance imaging study of intracranial vertebrobasilar artery dissections. Stroke 1994;25:571-575.

[14] 14. Milandre L, Martini P, Perot S, Mercier C. Pure motor hemiparesis in a case of vertebrobasilar arterial ectasia. Neuroradiology 1993;35:196-198.

[15] 15. Mizutani T, Aruga T. Dolichoectatic intracranial vertebrobasilar dissecting aneurysm. Neurosurgery 1992;31:765-773.

[16] 16. Moseley IF, Holland IM. Ectasia of the basilar artery: the breadth of the clinical spectrum and the diagnostic value of computed tomography. Neuroradiology 1979; 18: 83-91.

[17] 17. Naseem M, Leehey P, Russell E, Sarwar M, Devasthali R. MR of basilar artery dolichoectasia. AJNR 1988;9:391-392.

[18] 18. Nijensohn DE, Saez RJ, Reagan TJ. Clinical significance of basilar artery aneurysms. Neurology 1974;24:301-305.

[19] 19. Nishizaki T, Tamaki N, Takeda N, Shirakuni T, Kondoh T, Matsumoto S. Dolichoectatic basilar artery: a review of 23 cases. Stroke 1986;17:1277-1281.

[20] 20. Peterson NT, Duchesneau PM, Westbrook EL, Weinstein MA. Basilar artery ectasia demonstrated by computed tomography. Radiology 1977; 122: 713-715.

[21] 21. Sacks JG, Lindenberg R. Symptomatology and pathology of arterial elongation and distention. Hopkins Med J 1969;125:95-106.

[22] 22. Schwaighofer BW, Klein MV, Lyden PD, Hesselink JR. MR imaging of vertebrobasilar vascular disease. J Comput Assist Tomogr 1990;14:895-904.

[23] 23. Scotti G, De Grandi C, Colombo A. Ectasia of the intracranial arteries diagnosed by computed tomography: megadolichobasilar artery CT diagnosis. Neuroradiology 1978;15:183-184.

[24] 24. Smoker WR, Price MJ, Keyes WD, Corbett JJ, Gentry LR. High-resolution computed tomography of the basilar artery: 1. Normal size and position. AJNR 1986;7:55-60.

[25] 25. Smoker WR, Corbett JJ, Gentry LR, Keyes WD, Price MJ, McKusker S. High-resolution computed tomography of the basilar artery: 2. Vertebrobasilar dolichoectasia: clinical-pathologic correlation and review. AJNR 1986;7:61-72.

[26] 26. Waga S, Morikawa A, Kojima T. Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery. Surg Neurol 1979;11:13-16.

[27] 27. Wallace S, Jaffe ME. Cerebral arterial ectasia with saccular aneurysms. Radiology 1967;88:90-93.

[28] 28. Watanabe T, Sato K, Yoshimoto T. Basilar artery occlusion caused by thrombosis of atherosclerotic fusiform aneurysm of the basilar artery. Stroke 1994;25:1068-1070.

[29] 29. Whisnant J P, Bacford JR, Bernstein EF, et al. Classification of cerebrovascular disease III. Stroke 1990-,21:637-676.

[30] 30. Yu Y, Moseley I, Pullicino P, McDonald W. The clinical picture of ectasia of the intracerebral arteries. J Neurol Neurosurg Psychiatry 1982;45:29-36.