Presentation
Difficulty walking for a day of evolution. History of arterial hypertension 20 years ago.
Patient Data
In the carotid Doppler performed, the right vertebral artery was not visible at the time of the study, so occlusion or hypoplasia/agenesis of the same is suspected. The left vertebral artery was considered normal.
The neck angiotomography shows that the right vertebral artery is decreased in diameter from its origin in the subclavian artery compared to its contralateral (left vertebral artery). Both vertebral arteries have adequate passage of contrast medium throughout their course; the right vertebral artery measures 1.6 mm and the left vertebral artery measures 4.3 mm, a finding compatible with hypoplasia of the right vertebral artery.
Case Discussion
a luminal diameter <2 mm, accompanied by decreased flow in the posterior cerebral circulation, is often used to define vertebral artery hypoplasia
there must be >40% asymmetry to determine that unilateral hypoplasia exists
angiotomography, magnetic resonance angiography, and angiography allow evaluation of the entire course of the vertebral arteries to determine the presence of hypoplasia
the results of the studies published so far suggest a relationship between vertebral artery hypoplasia and an increased risk of ischemic stroke or transient ischemic attack in the posterior vascular area of the brain
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