Vertebral artery ectasia
Updates to Article Attributes
Vertebral artery ectasia refers to an abnormal dilatation of the vertebral artery. It is also known as a dolichoarterial loop (of Danziger).
Clinical presentation
Symptoms occur due to radicular compression or pathologic fracture (rare) from extensive bone erosion. Generally, patients present with headache, dizziness, suboccipital pain, nausea and vomiting.
Pathology
Vertebral arterial wall thinning and elongation (usually age-related); the majority are unilateral.
Occlusion of the carotid arteries (bilaterally) may precipitate vertebral artery dilatation as a compensatory mechanism for maintaining cerebral perfusion 1.
Radiographic features
Plain radiograph
- enlargement of the transverse foramen
- erosion of pedicle and posterolateral vertebral body expanding the intervertebral foramen
- extrinsic bone erosion seen in the mid cervical segments, usually at C4-C5 level (Hadley’serosive defect)
CT
Allows better visualisation of plain film findings
MRI
MRA is best method to confirm the presence of a dolichoectatic loop or dolichoarterial loop.
Differential diagnosis
Consider other vascular causes of pedicle erosion:
- arteriovenous malformation
- pseudoaneurysm
- aortic coarctation
- subclavian steal syndrome
- carotid obstruction
-<p><strong>Vertebral artery ectasia </strong>refers to an abnormal dilatation of the <a title="Vertebral artery" href="/articles/vertebral-artery">vertebral artery</a>. It is also known as a <strong>dolichoarterial loop</strong> (<strong>of Danziger</strong>).</p><h4>Clinical presentation</h4><p>Symptoms occur due to radicular compression or pathologic fracture (rare) from extensive bone erosion. Generally, patients present with headache, dizziness, suboccipital pain, nausea and vomiting. </p><h4>Pathology</h4><p>Vertebral arterial wall thinning and elongation (usually age-related); the majority are unilateral.</p><p>Occlusion of the carotid arteries (bilaterally) may precipitate vertebral artery dilatation as a compensatory mechanism for maintaining cerebral perfusion <sup>1</sup>.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><ul>- +<p><strong>Vertebral artery ectasia </strong>refers to an abnormal dilatation of the <a href="/articles/vertebral-artery">vertebral artery</a>. It is also known as a <strong>dolichoarterial loop</strong> (<strong>of Danziger</strong>).</p><h4>Clinical presentation</h4><p>Symptoms occur due to radicular compression or pathologic fracture (rare) from extensive bone erosion. Generally, patients present with headache, dizziness, suboccipital pain, nausea and vomiting. </p><h4>Pathology</h4><p>Vertebral arterial wall thinning and elongation (usually age-related); the majority are unilateral.</p><p>Occlusion of the carotid arteries (bilaterally) may precipitate vertebral artery dilatation as a compensatory mechanism for maintaining cerebral perfusion <sup>1</sup>.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><ul>
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