Clinical Characteristics of Patients with Vertebral Artery Hypoplasia

Vertebral artery hypoplasia (VAH) belongs to the relatively frequent Doppler ultrasonography (US) findings. However, its clinical significance remains controversial. This was a retrospective study analyzing clinical data of patients undergoing US because of cerebrovascular disease in a single academic neurology center. In the dataset of 2500 US examinations, 80 individuals with VAH (VA diameter < 2.0 mm) were identified (3.2% of all patients). Patients with significant vertebral artery asymmetry (SVAA, difference in VA diameters > 1.0 mm) (n = 80) and patients with normal VA diameter (n = 80) were also recruited. Clinical parameters including clinical signs and symptoms, concomitant diseases, imaging findings and the hospitalization outcome were compared between groups. The frequency of vertigo was highest in VAH group. Ischemic lesions of the cerebellum were found in 10% of VAH patients, 16% of SVAA patients and 5% of control subjects. Neurological deficits improved in over 60% of patients in each group, whereas ca. 30% of patients remained in a stable neurological status. The percentage of patients who deteriorated did not exceed 5% in any of the groups. The results of our study support a relatively high frequency of VAH. Our observations suggest coexistence of VAH with a higher frequency of neurological presentations associated with posterior arterial circulation of the central nervous system.

Automated summary

Vertebral artery hypoplasia (VAH) is a relatively frequent finding in Doppler ultrasonography, but its clinical significance is controversial. This study found a higher frequency of neurological symptoms associated with posterior arterial circulation in patients with VAH.