Revision 7 for 'Vertebral artery ectasia'

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Vertebral artery ectasia

Vertebral artery ectasia refers to an abnormal dilatation of the vertebral artery. It is also known as a Dolicoarterial loop (of Danziger).

Pathology

Vertebral arterial wall thinning and elongation (usually age-related); majority are unilateral.

Occlusion of the carotid arteries (bilaterally) may precipitate vertebral artery dilatation as a compensatory mechanism for maintaining cerebral perfusion 1.

Clinical presentation

Symptoms occur due to radicular compression or pathologic fracture (rare) from extensive bone erosion. 

Generally patient presents with headache, dizziness, sub occipital pain,nausea and vomiting. 

Radiographic features

Plain film
  • enlargement of the transverse foramen
  • erosion of pedicle and posterolateral vertebral body expanding the intervertebral foramen
  • extrinsic bone erosion seen in the midcervical segments, usually at C4-C5 level
CT

better visualization of plain film findings

MRA

Best method to confirm the presence of a dolicoectatic loop or dolicoarterial loop.

Differential diagnosis

Consider other vascular causes of pedicle erosion:

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