Pathogenetical and pathophysiological mechanisms of the formation of acute and chronic vertebrobasilar blood flow insufficiency in patients with Chiari i malformation
Krupina N.E.
Abstract. 195 patients with Chiari malformation were examined. 77 of them were examined with a help of magnetic resonance angiography and 161 — with transcranial dopplerography. Magnetic resonance angiography data analysis revealed the frequent presence of vertebrobasilar system maldevelopment and embryonic type of the circle of Willis: unilateral and bilateral fetal-type posterior communicating arteries, persistent caroticobasilar anastomoses, vertebral or basilar artery hypoplasias. Transcranial dopplerography data analysis discovered vertebrobasilar insufficiency and compensated blood flow from the carotid system. The size of malformation, concomitant intracranial hypertension and syringomyelia have an effect upon the cerebral blood flow data.
Keywords: circle of Willis, Chiari malformation, cerebral hemodynamics
REFERENCES
1. Milhorat Th.H., Chou M.W., Trinidad E.M., Kula R.W., Mandell M., Wolpert Ch., Speer M.C. Chiari I malformation redefined: Clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1999; 44 (5): 1005-1017.
2. Matsumura M., Nojiri K., Yumoto Y. Persistent primitive hypoglossal artery associated with Arnold-Chiari type I malformation. Surgical Neurology. 1985; 24 (3): 241-244.
3. Gabrielsen T.O., Seeger J.F., Amundsen P. Some new angiographic observations in patients with Chiari type I and II malformations. Radiology. 1975; 115 (3): 627-634.
4. Occleshaw J.V. The posterior inferior cerebellar arteries. Some quantitative observations in posterior cranial fossa tumours and the Arnold-Chiari malformation. Clin. Radiol. 1970; 21 (1): 1-9.
5. Rousseaux M., Salomez J.L., Petit H. Syncopes and transitory neurologic manifestations revealing cervico-occipital joint malformations. Evidence of a vascular mechanism. Sem. Hop. 1983; 59 (11): 729-732.
6. Margolis M.T., Newton T.H. An angiographic sign of cerebellar tonsillar herniation. Neuroradiology. 1971; 2: 3-8.
7. Padget D.H. The development of the cranial arteries in the human embrio. Embriology and anatomy in intracranial aneurysms. Ed. Dandy W. New York. 1947; 1: 207-259.
8. Mayer P.L., Kier E.L. The ontogenetic and phylogenetic basis of cerebrovascular anomalies and variants. NY: Churchill Livingstone 1993; 691-792.
9. Maki Y., Sueyoshi N., Shiraishi H., Moriya K. Studies of persistent carotid-basilar anastomosis. Report of a case with persistent hypoglossal artery associated with Arnold-Chiari malformation. Clin. Neurol. (Tokyo). 1965; 5: 278-285.
10. da Silva J.A., Brito J.C., da Nobrega P.V., Costa M. do D., de Souza A.B. Surgical findings in 260 cases of basilar impression and/or Arnold-Chiari malformation. Arq. Neuropsiquiatr. 1994; 52 (3): 363-369.
Author
Krupina Natalia E.
Ural State Medical University Ministry of Health of Russian Federation
Doctor of Medical Sciences, Professor of the Department of Nervous Diseases, Neurosurgery and Medical Genetics
Russian Federation, 620219, Yekaterinburg, 3 Repina Str.
krupina@gkb40.ur.ru
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)