TY - JOUR
T1 - Laterality of deep white matter hyperintensities correlates with basilar artery bending and vertebral artery dominance
AU - Szalontai, Laszlo
AU - Jokkel, Zsofia
AU - Horvath, Tamas
AU - Forgo, Bianka
AU - Kalina, Ildiko
AU - Maurovich-Horvat, Pal
AU - Auyang, Philip L.
AU - Zubair, M. Mujeeb
AU - Garami, Zsolt
AU - Tarnoki, David Laszlo
AU - Tarnoki, Adam Domonkos
N1 - Funding Information:
Received from the Erasmus + program (16-1/KA1ICM/OUT/022662/SMS-07) to LSz.
Publisher Copyright:
© 2021 Medicinska Naklada Zagreb. All rights reserved.
PY - 2021/8
Y1 - 2021/8
N2 - Aim To investigate whether vertebrobasilar geometry contributes to the presence, severity, and laterality of white matter hyperintensities (WMH). Methods We retrospectively reviewed 290 cerebral scans of patients who underwent time-of-flight and fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) between 2017 and 2018. WMH were counted, localized, and grouped according to laterality on the FLAIR sequence. A 3D mesh of the posterior circulation was reconstructed (with ITK SNAP software) and the morphology of the vertebrobasilar system analyzed with an in-house software written in Python. Results Patients were assigned into a group with WMH (n = 204) and a group without WMH (n = 86). The severity of WMH burden was mainly affected by age and hypertension, while the localization of the WMH (or laterality) was mainly affected by the vertebrobasilar system morphology. Basilar artery morphology only affected the parietooccipital region significantly if both posterior communicating arteries were hypoplastic or absent. The dominant vertebral artery and basilar artery curve had an opposite directional relationship. Conclusions An unequal vertebral artery flow is an important hemodynamic contributor to basilar bending. Increased basilar artery curvature and increased infratentorial WMH burden may signal inadequate blood flow and predict cerebrovascular events.
AB - Aim To investigate whether vertebrobasilar geometry contributes to the presence, severity, and laterality of white matter hyperintensities (WMH). Methods We retrospectively reviewed 290 cerebral scans of patients who underwent time-of-flight and fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) between 2017 and 2018. WMH were counted, localized, and grouped according to laterality on the FLAIR sequence. A 3D mesh of the posterior circulation was reconstructed (with ITK SNAP software) and the morphology of the vertebrobasilar system analyzed with an in-house software written in Python. Results Patients were assigned into a group with WMH (n = 204) and a group without WMH (n = 86). The severity of WMH burden was mainly affected by age and hypertension, while the localization of the WMH (or laterality) was mainly affected by the vertebrobasilar system morphology. Basilar artery morphology only affected the parietooccipital region significantly if both posterior communicating arteries were hypoplastic or absent. The dominant vertebral artery and basilar artery curve had an opposite directional relationship. Conclusions An unequal vertebral artery flow is an important hemodynamic contributor to basilar bending. Increased basilar artery curvature and increased infratentorial WMH burden may signal inadequate blood flow and predict cerebrovascular events.
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U2 - 10.3325/cmj.2021.62.360
DO - 10.3325/cmj.2021.62.360
M3 - Article
C2 - 34472739
AN - SCOPUS:85115278698
SN - 0353-9504
VL - 62
SP - 360
EP - 366
JO - Croatian Medical Journal
JF - Croatian Medical Journal
IS - 4
ER -