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Lee JH, Vu HD, Park MH, Huynh PT, Youn SW, Kwon DR. Microcurrent wave alleviates mouse intracranial arterial dolichoectasia development. Sci Rep 2024; 14:7496. [PMID: 38553592 PMCID: PMC10980802 DOI: 10.1038/s41598-024-58333-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/27/2024] [Indexed: 04/02/2024] Open
Abstract
Intracranial arterial dolichoectasia (IADE) is associated with the interaction of hypertension and inflammation, and microcurrent can be effective in hypertension. Therefore, this study aimed to investigate the therapeutic effect of microcurrent electrical stimulation in a mouse IADE model. This study randomly categorized 20 mice into five groups: group 1-C (healthy control), group 2-D (IADE model), group 3-M + D (microcurrent administration before nephrectomy and until brain surgery), group 4-D + M (microcurrent administration for 4 weeks following brain surgery), and group 5-M (microcurrent administration for 4 weeks). Cerebral artery diameter and thickness and cerebral arterial wall extracellular matrix components were assessed. Among the five groups, group 2-D showed significantly higher cerebral arterial wall diameter (117.79 ± 17.05 µm) and proportion of collagen (42.46 ± 14.12%) and significantly lower arterial wall thickness (9.31 ± 2.26 µm) and proportion of smooth muscle cell (SMC) and elastin in the cerebral arterial wall (SMC: 38.05 ± 10.32%, elastin: 11.11 ± 6.97%). Additionally, group 4-D + M exhibited a non-significantly lower diameter (100.28 ± 25.99 µm) and higher thickness (12.82 ± 5.17 µm). Group 5-M demonstrated no evidence of toxicity in the liver and brain. The pilot study revealed that microcurrent is effective in preventing IADE development, although these beneficial effects warrant further investigation.
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Affiliation(s)
- Jae Hee Lee
- Department of Rehabilitation Medicine, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Huy Duc Vu
- Department of Radiology, Kyungpook National University, Daegu, South Korea
| | - Min Hee Park
- Department of Radiology, Kyungpook National University, Daegu, South Korea
| | - Phuong Tu Huynh
- Department of Radiology, Kyungpook National University, Daegu, South Korea
| | - Sung Won Youn
- Department of Radiology, Kyungpook National University, Daegu, South Korea.
| | - Dong Rak Kwon
- Department of Rehabilitation Medicine, Daegu Catholic University School of Medicine, Daegu, South Korea.
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Vadhanan P. Dolichoectasia of vertebrobasilar artery presenting as facial pain: a case report. J Dent Anesth Pain Med 2023; 23:237-240. [PMID: 37559669 PMCID: PMC10407453 DOI: 10.17245/jdapm.2023.23.4.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/04/2023] [Accepted: 07/02/2023] [Indexed: 08/11/2023] Open
Abstract
Dolichoectasia of the intracranial arteries is a rare condition characterized by elongated and tortuous arteries due to progressive destruction of the vessel walls. Although most patients present with cerebrovascular accidents, our patient presented with intractable facial pain along the distribution of the trigeminal nerve. Clinical examination revealed involvement of the 5th, 7th, and 8th cranial nerves, and subsequent MRI showed dolichoectasia of the left basilar artery. The patient experienced symptomatic relief after a trial of carbamazepine along with botulinum toxin injections.
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Affiliation(s)
- Prasanna Vadhanan
- Department of Anaesthesiology, Vinayaka Missions Medical College and Hospitals, Vinayaka Missions Research Foundation, Karaikal, India
- Pain Clinic, Mayiladuthurai, India
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Frosolini A, Fantin F, Caragli V, Franz L, Fermo S, Inches I, Lovato A, Genovese E, Marioni G, de Filippis C. Vertebrobasilar and Basilar Dolichoectasia Causing Audio-Vestibular Manifestations: A Case Series with a Brief Literature Review. Diagnostics (Basel) 2023; 13:diagnostics13101750. [PMID: 37238234 DOI: 10.3390/diagnostics13101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Audio-vestibular symptoms can arise from vertebrobasilar dolichoectasia (VBD) and basilar dolichoectasia (BD). Given the dearth of available information, herein we reported our experience with different audio-vestibular disorders (AVDs) observed in a case series of VBD patients. Furthermore, a literature review analyzed the possible relationships between epidemiological, clinical, and neuroradiological findings and audiological prognosis. The electronic archive of our audiological tertiary referral center was screened. All identified patients had a diagnosis of VBD/BD according to Smoker's criteria and a comprehensive audiological evaluation. PubMed and Scopus databases were searched for inherent papers published from 1 January 2000 to 1 March 2023. Three subjects were found; all of them had high blood pressure, and only the patient with high-grade VBD showed progressive sensorineural hearing loss (SNHL). Seven original studies were retrieved from the literature, overall including 90 cases. AVDs were more common in males and present in late adulthood (mean age 65 years, range 37-71), with symptoms including progressive and sudden SNHL, tinnitus, and vertigo. Diagnosis was made using different audiological and vestibular tests and cerebral MRI. Management was hearing aid fitting and long-term follow-up, with only one case of microvascular decompression surgery. The mechanism by which VBD and BD can cause AVD is debated, with the main hypothesis being VIII cranial nerve compression and vascular impairment. Our reported cases suggested the possibility of central auditory dysfunction of retro-cochlear origin due to VBD, followed by rapidly progressing SNHL and/or unnoticed sudden SNHL. More research is needed to better understand this audiological entity and achieve an evidence-based effective treatment.
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Affiliation(s)
- Andrea Frosolini
- Phoniatris and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Francesco Fantin
- Phoniatris and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
| | - Valeria Caragli
- Audiology Unit, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Leonardo Franz
- Phoniatris and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
- Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, 25100 Brescia, Italy
| | - Salvatore Fermo
- Phoniatris and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
| | - Ingrid Inches
- Neuroradiology Unit, Treviso Hospital, 31100 Treviso, Italy
| | - Andrea Lovato
- Otorhinolaryngology Unit, Department of Surgical Specialties, Vicenza Civil Hospital, 36100 Vicenza, Italy
| | - Elisabetta Genovese
- Audiology Unit, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Gino Marioni
- Phoniatris and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
| | - Cosimo de Filippis
- Phoniatris and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
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Cao S, Zhai M, He J, Wang J, Ge T, Wu Q, Ni X, Cui P, Xu W, Xia M. Basilar artery curvature increases the risk of posterior circulation infarction occurrence in patients without vertebrobasilar stenosis. Neurol Sci 2023; 44:1273-1280. [PMID: 36564659 PMCID: PMC10023619 DOI: 10.1007/s10072-022-06566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Limited cross-sectional or case-control studies have identified the relationship between basilar artery (BA) curvature and posterior circulation infarction (PCI). This study aimed to identify the influence of BA curvature severity on the risk of PCI occurrence in patients without vertebrobasilar stenosis through a prospective cohort study. METHODS In this study, we enrolled 171 patients with BA dolichosis but without vertebrobasilar stenosis. The BA geometric parameters were evaluated on MRA. The primary outcome was the occurrence of PCI, mainly referring to cerebellar and/or brainstem infarction. Cox proportional hazard models were used to detect possible predictors of PCI. RESULTS Among them, 134 (78.4%) patients were diagnosed with BA curvature, including 124 with moderate curvature and 10 with prominent curvature. The defined PCI occurrence was observed in 32 (18.7%) patients with a median follow-up time of 45.6 months. Cox proportional hazard analysis showed that BA prominent curvature (HR = 6.09; 95% CI: 1.36-27.28; P = 0.018) significantly increased the risk of PCI occurrence, and bending length (BL) was also significantly associated with PCI occurrence, with the adjusted HR per 1-mm increase of BL of 1.09 (95% CI: 1.01-1.18; P = 0.040). In the subgroup analysis stratified by age, BA prominent curvature was highly associated with PCI occurrence in patients aged > 61 years (HR = 11.76; 95% CI: 1.21-113.90; P = 0.033). Additionally, good antiplatelet therapy adherence could significantly reduce the risk of PCI occurrence. CONCLUSION BA curvature may increase the risk of PCI occurrence, especially in elderly patients with prominent curvature. Improving adherence to antiplatelet therapy can help reduce the risk of PCI occurrence.
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Affiliation(s)
- Shugang Cao
- grid.186775.a0000 0000 9490 772XDepartment of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
| | - Mingfeng Zhai
- Department of Neurology, Fuyang People’s Hospital, Sanqing Road, Fuyang, 236000 China
| | - Jun He
- grid.186775.a0000 0000 9490 772XDepartment of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
| | - Jian Wang
- grid.186775.a0000 0000 9490 772XDepartment of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
| | - Tingting Ge
- grid.186775.a0000 0000 9490 772XDepartment of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
| | - Qian Wu
- grid.186775.a0000 0000 9490 772XDepartment of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
| | - Xiaoxing Ni
- grid.186775.a0000 0000 9490 772XDepartment of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
| | - Ping Cui
- grid.186775.a0000 0000 9490 772XDepartment of Radiology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
| | - Wen’an Xu
- grid.186775.a0000 0000 9490 772XDepartment of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
| | - Mingwu Xia
- grid.186775.a0000 0000 9490 772XDepartment of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011 China
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Wang Y, Yu J. Prospects and Dilemmas of Endovascular Treatment for Vertebrobasilar Dolichoectasia. Front Neurol 2022; 13:895527. [PMID: 35865646 PMCID: PMC9294217 DOI: 10.3389/fneur.2022.895527] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/15/2022] [Indexed: 12/03/2022] Open
Abstract
Vertebrobasilar dolichoectasia (VBD) is characterized by significant expansion, elongation, and tortuosity of the basilar artery and vertebral artery. Certain highly selected cases of VBD can require intervention. Recent advances in endovascular treatment (EVT) have renewed hope for patients with VBD. However, which cases of VBD can benefit from EVT still needs to be determined. Currently, little is known regarding this matter. Therefore, we performed a review of the literature from a PubMed search and cataloged our experience regarding the classification and natural history of VBD and the prospects, prognosis and complications of EVT. The findings can be summarized as follows: for asymptomatic VBD, “wait and see” or medical management may be a reasonable strategy. EVT may only be effective in certain patients. For saccular aneurysms in VBD, especially ruptured aneurysms, EVT is reasonable. For fusiform aneurysms in VBD, EVT can carry high complication rates and should be recommended with caution. For stenting reconstruction in VBD, the effect is uncertain. For the future of EVT of VBD, randomized controlled trials and the development of neurointerventional products are worth pursuing, but EVT in VBD still has a long way to go.
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Affiliation(s)
| | - Jinlu Yu
- *Correspondence: Jinlu Yu ; /0000-0003-2329-7946
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