Basilar artery hypoplasia associated with changes of brainstem potential, transcranial Doppler and perfusion-weighted imaging

Abstract

Objective: The aim of this study was to observe brainstem hemodynamic alterations associated with basilar artery hypoplasia (BAH). Methods: Nine hundred and fifty-two consecutive patients received emergency multimodal computed tomography; magnetic resonance imaging and magnetic resonance angiogram during the period of January 2011 to December 2014 were included. The vascular risk factors, brainstem auditory evoked potential (BAEP), blink reflex (BR), transcranial Doppler (TCD) and dynamic susceptibility contrast-enhanced perfusion-weighted imaging were completed. Results: There was significant difference in the abnormal rates of TCD and BAEP between BAH and non-BAH patients. A positive correlation between basilar artery diameter and systolic velocity among BAH patients was suggested. V-wave value was used to predict posterior circulation infarction (PCI) with the sensitivity of 0.933 and specificity of 0.50 with the cutoff value of 5.97 s. Abnormal BR rate was also significantly different in BAH and non-BAH patients. The latency of R2 was used to predict PCI with the sensitivity of 0.933 and specificity of 0.50 with the cutoff value of 46.4 ms. The incidence of hypoperfusion was higher in BAH than non-BAH group and it was significant difference. Conclusion: BAH is closely associated with hemodynamic alterations within the pons, which might contribute to vascular vertigo due to regional hypoperfusion.

KEYWORDS:

• basilar artery hypoplasia
• brainstem auditory evoked potential
• blink reflex
• perfusion-weighted imaging
• vertigo

Declaration of Interest

There is no conflict of interest associated with this manuscript.

This study was supported by the National Natural Science Foundation of China (NSFC) [grant number 81471203]; Science and Technology Project of Zhengzhou City [grant number 20130559] and a grant from Medical Science and Technology Project from Henan Province Health and Family Planning Commission [grant number 201303224].

Additional information

Funding

This study was supported by the National Natural Science Foundation of China (NSFC) [grant number 81471203]; Science and Technology Project of Zhengzhou City [grant number 20130559] and a grant from Medical Science and Technology Project from Henan Province Health and Family Planning Commission [grant number 201303224].