For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
8
views
22
references
 Top references
cited by
1
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      744
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      A case of multiple Vertebrobasilar artery fenestration misdiagnosed as vertebral artery dissection

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Fenestration of vertebra-basilar artery is an uncommon congenital vascular anomaly, which is identified by incidental findings on imaging in patients presented without related symptoms or in patients with intracerebral hemorrhage secondary to concomitant artery aneurysm or arteriovenous malformations. Yet, cases of fenestration being misdiagnosed as cerebral artery dissection have never been reported.

          Case presentation

          We present a patient of 66-year-old female with acute onset of dizziness after chiropractic manipulation of the neck. Neck computed tomography angiography (CTA) showed ‘double lumen’ sign and ‘intimal flap’ of the V1 segment of the vertebral artery, which led to the initial diagnosis of vertebral artery dissection (VAD). However, vertebral artery fenestration at V1 segment was eventually identified by multi-directional digital subtraction angiography (DSA). Interestingly, concomitant vertebral fenestration at V3 segment, basilar fenestration and basilar artery tip aneurysm was also revealed by DSA.

          Conclusion

          The triple fenestration at vertebrobasilar artery with basilar tip artery aneurysm is extremely rare, and the fenestration at the V1 segment of vertebral artery was easily misdiagnosed as VAD due to the similar imaging morphology.

          Related collections

          Most cited references22

          • Record: found
          • Abstract: found
          • Article: not found

          Comparison of test performance characteristics of MRI, MR angiography, and CT angiography in the diagnosis of carotid and vertebral artery dissection: a review of the medical literature.

          Basar Sarikaya, James M. Provenzale (2009)
          Initial assessment of patients with suspected dissection of the carotid or vertebral arteries typically is made by MRI, alone or in combination with MR angiography (MRA) or CT angiography (CTA). We reviewed the medical literature to determine, based on test performance characteristics such as sensitivity, specificity, positive predictive value, and negative predictive value, whether evidence could be found to support routine use of one imaging technique over the other for assessment of suspected dissection. Test characteristics for MR techniques such as MRI and MRA were relatively similar to those for CTA in diagnosis of carotid and vertebral artery dissection.
          Article 0 comments Cited 34 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Current Understanding and Gaps in Research of Carotid Webs in Ischemic Strokes

            Song Kim, Raul Nogueira, Diogo C Haussen (2018)
            A succession of research has explored the linkage between carotid webs (CaWs) and ischemic strokes. Imaging and pathologic analysis have defined CaW as an intimal variant of fibromuscular dysplasia, which appears as a shelflike lesion on the posterior aspect of the carotid bulb, more specifically at the origin of internal carotid artery. Reported findings of carotid webs in young patients with recurrent ischemic strokes without an otherwise determined cause have raised questions about the mechanism, natural history, and need for intervention. This review addresses the current understanding of CaW and highlights findings that prompt further investigation into this unique vascular entity as a modifiable stroke risk factor.
            Article 0 comments Cited 33 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Cerebral arterial fenestrations.

              Daniel L. Cooke, Charles E. Stout, Warren Kim … (2014)
              Arterial fenestrations are an anatomic variant with indeterminate significance. Given the controversy surrounding fenestrations we sought their prevalence within our practice along with their association with other cerebrovascular anomalies. We retrospectively reviewed 10,927 patients undergoing digital subtraction angiography between 1992 and 2011. Dictated reports were searched for the terms "fenestration" or "fenestrated" with images reviewed for relevance, yielding 228 unique cases. A Medline database search from February 1964 to January 2013 generated 304 citations, 127 cases of which were selected for analysis. Cerebral arterial fenestrations were identified in 228 patients (2.1%). At least one aneurysm was noted in 60.5% of patients, with an aneurysm arising from the fenestration in 19.6% of patients. Aneurysmal subarachnoid hemorrhage or non-aneurysmal subarachnoid hemorrhage were present in 60.1% and 15.8%, respectively. For the subset of patients with an aneurysm arising directly from a fenestration relative to those patients with an aneurysm not immediately associated with a fenestration, the prevalence of aneurysmal subarachnoid hemorrhage was 66.7% vs. 58.6% (p = 0.58). Fenestrations were more often within the posterior circulation (73.2%) than the anterior circulation (24.6%), though there was no difference in the prevalence of aneurysms within these groups (61.1% vs. 60.7%, p = 1.0). Cerebral arterial fenestrations are an anatomic variant more often manifesting at the anterior communicating arterial complex and basilar artery and with no definite pathological relationship with aneurysms.
              Article 0 comments Cited 17 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Zhiyong Zhang:
                ORCID: http://orcid.org/0000-0002-7722-6986
                zhiyong_zhang888@126.com
                Journal
                Journal ID (nlm-ta): BMC Neurol
                Journal ID (iso-abbrev): BMC Neurol
                Title: BMC Neurology
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2377
                Publication date (Electronic): 20 February 2020
                Publication date PMC-release: 20 February 2020
                Publication date Collection: 2020
                Volume: 20
                Electronic Location Identifier: 63
                Affiliations
                [1 ]GRID grid.452746.6, Department of Neurology, Seventh People’s Hospital of Shanghai, , University of Traditional Chinese Medicine, ; Shanghai, China
                [2 ]Department of Neurology, She Country Hospital, Hebei, China
                [3 ]GRID grid.415954.8, ISNI 0000 0004 1771 3349, Department of Neurology, , China-Japan Friendship Hospital, ; Beijing, China
                Author information
                http://orcid.org/0000-0002-7722-6986
                Article
                Publisher ID: 1642
                DOI: 10.1186/s12883-020-01642-2
                PMC ID: 7033924
                PubMed ID: 32079531
                SO-VID: a9d1c206-a390-4340-a632-52e517d3ef94
                Copyright © © The Author(s) 2020
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 23 July 2019
                Date accepted : 12 February 2020
                Funding
                Funded by: Research Fund of the China-Japan Friendship Hospital
                Award ID: 2015-2-QN-39
                Funded by: shanghai natural science fund
                Award ID: 18ZR14307000
                Award Recipient :
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2020

                ScienceOpen disciplines: Neurology
                Keywords: vertebrobasilar system,fenestration,vertebral artery dissection (vad),anomaly,arterial variation
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: vertebrobasilar system, fenestration, vertebral artery dissection (vad), anomaly, arterial variation

                Comments

                Comment on this article

                scite_

                Similar content744

                See all similar

                Cited by1

                See all cited by

                Most referenced authors196

                See all reference authors