DOI QR코드

DOI QR Code

Large Dolichoectasia Concurrently Involving Both Anterior and Posterior Cerebral Circulation: A Case Report

전순환계와 후순환계를 동시에 침범한 긴머리확장증 환자의 영상 소견: 증례 보고

  • Youngsoo Soh (Department of Radiology, Presbyterian Medical Center) ;
  • Soo Jung Kim (Department of Radiology, Presbyterian Medical Center) ;
  • Eun Ae Yoo (Department of Radiology, Presbyterian Medical Center)
  • 소영수 (전주예수병원 영상의학과) ;
  • 김수정 (전주예수병원 영상의학과) ;
  • 유은애 (전주예수병원 영상의학과)
  • Received : 2021.11.30
  • Accepted : 2022.04.14
  • Published : 2022.09.01

Abstract

Dolichoectasia is an uncommon disorder characterized by the presence of a dilated, elongated, and tortuous cerebral artery. Its main pathologic mechanism is the disruption of the internal elastic lamina. Risk factors for dolichoectasia are advanced age, chronic hypertension, and metabolic disease. It mainly involves the vertebrobasilar vasculature (or "posterior circulation"), but dolichoectasia can also be seen in the anterior circulation, particularly the anterior cerebral artery. There are no reported cases of dolichoectasia involving both anterior and posterior circulation in South Korea. Here we report an unusual case of dolichoectasia involving both anterior and posterior circulation in a young female without any underlying disease on the basis of prominent imaging findings.

긴머리확장증은 확장, 연장 및 구불구불한 형태의 대뇌동맥을 특징으로 하는 드문 질환이다. 주요 병리기전은 내탄력판의 파괴로 알려져 있으며, 위험요인으로 고령, 만성 고혈압, 그리고 대사성 질환 등이 있다. 긴머리확장증은 주로 후순환계의 척추뇌기저동맥을 침범하는 것으로 알려져 있으나, 전순환계, 특히 전대뇌동맥에 이환되는 경우도 있다. 긴머리확장증이 전순환계와 후순환계를 모두 침범한 사례는 아직 국내에 보고된 바가 없다. 이에 우리는 기저 질환이 없는 젊은 여자 환자에서 전순환계와 후순환계가 모두 이환된 매우 희귀한 형태의 긴머리확장증 사례를 현저한 영상 소견을 토대로 보고하고자 한다.

Keywords

References

  1. Gutierrez J, Sacco RL, Wright CB. Dolichoectasia-an evolving arterial disease. Nat Rev Neurol 2011;7:41-50
  2. Del Brutto VJ, Ortiz JG, Biller J. Intracranial arterial dolichoectasia. Front Neurol 2017;8:344
  3. Uchino A, Kohyama S. Long segment dolichoectasia of the right internal carotid artery diagnosed by CT angiography. Radiol Case Rep 2019;14:1084-1087
  4. Tien KL, Yu IK, Yoon SJ, Yoon YK. CT and MR imaging features in patients with intracranial dolichoectasia. J Korean Radiol Soc 2000;42:205-214
  5. Kim JY, Kim JW, Yoon MJ, Suk SH. Acute subarachnoid hemorrhage due to giant vertebrobasilar dolichoectasia. J Neurocrit Care 2019;12:117-121
  6. Samim M, Goldstein A, Schindler J, Johnson MH. Multimodality imaging of vertebrobasilar dolichoectasia: clinical presentations and imaging spectrum. Radiographics 2016;36:1129-1146
  7. Yuh SJ, Alkherayf F, Lesiuk H. Dolichoectasia of the vertebral basilar and internal carotid arteries: a case report and literature review. Surg Neurol Int 2013;4:153
  8. Kim BS, Lee JG, Ahn S, Park JH. Huge vertebrobasilar dolichoectasia. J Korean Neurol Assoc 2019;37:432-434
  9. Nouh A, Remke J, Ruland S. Ischemic posterior circulation stroke: a review of anatomy, clinical presentations, diagnosis, and current management. Front Neurol 2014;5:30
  10. Passero SG, Rossi S. Natural history of vertebrobasilar dolichoectasia. Neurology 2008;70;66-72