Toward a further elucidation: role of vertebral artery hypoplasia in acute ischemic stroke

Eur Neurol. 2006;55(4):193-7. doi: 10.1159/000093868. Epub 2006 Jun 13.


Background and purpose: Congenital vertebral artery (VA) hypoplasia is an uncommon embryonic variation of posterior circulation. The frequency of this congenital variation was reported to be 2-6% from autopsy and angiograms. The aim of our study was to elucidate the role of VA hypoplasia in acute ischemic stroke.

Method: We examined 191 acute ischemic stroke patients (age 55.8 +/- 14.0 years). TOAST subtypes were determined. A cervical magnetic resonance angiogram was performed in every patient. A duplex study of bilateral VA with flow velocities and vessel diameter recording in the intertransverse (V2) segment was performed within 72 h after onset of ischemic stroke. The net VA flow volume was measured in each subject.

Result: The overall incidence of a unilateral congenital hypoplastic VA was 11.51%, which was statistically higher especially in cases of brainstem/cerebellar infarction. Of these, subjects with VA hypoplasia had an etiological preponderance of the 'large-artery atherosclerosis' subtype and a topographic preponderance of ipsilateral posterior circulation infarction.

Conclusions: Based on our results, VA hypoplasia seemed a contributing factor of acute ischemic stroke, especially in posterior circulation territories.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atherosclerosis / epidemiology
  • Brain Ischemia / classification
  • Brain Ischemia / epidemiology
  • Brain Ischemia / physiopathology*
  • Cerebrovascular Circulation / physiology*
  • Congenital Abnormalities / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Risk Factors
  • Stroke / classification
  • Stroke / epidemiology
  • Stroke / physiopathology*
  • Vertebral Artery / abnormalities*