TYPES OF ANGIODYSPLASIA IN KIMMERLE ANOMALY BY MAGNETIC RESONANCE ANGIOGRAPHY
Keywords:
Kimmerle anomaly, magnetic resonance angiography, vertebrobasilar insufficiency, vertebral artery, angiodysplasiaAbstract
Introduction: Vascular diseases of the central nervous system are one of the leading causes of death in developed countries. Vertebrobasilar insufficiency (VBI), caused by compression of the vertebral artery in the atlantoaxial joint area, is considered a significant contributor. Kimmerle anomaly (KA), a congenital bony bridge of the atlas, can exacerbate this condition. This study explores the structural vascular changes associated with KA using magnetic resonance angiography (MRA).
Methods: We examined 106 patients diagnosed with KA from a cohort of 620 individuals presenting with headache. Patients underwent X-ray and MRA of the craniovertebral region. Vascular morphometry, anomalies in the cerebral arterial circle, and vertebral artery caliber were assessed. Special attention was given to hypoplasia, aplasia, tortuosity, and asymmetry.
Results: MRA revealed angiodysplasias in 96.5% of patients with KA. The most common findings included hypoplasia of the vertebral artery (17.9%), posterior cerebral circle discontinuity (40.6%), tortuosity of vessels in the vertebrobasilar region (37.7%), and internal carotid artery trifurcation (5.7%). Vertebral artery blood flow was slowed in 65.5% (right) and 87.3% (left). Symptoms were often aggravated by head movements.
Discussion: The study confirms a strong association between KA and structural vascular anomalies, emphasizing the role of MRA in their identification. The presence of KA combined with these angiodysplasias increases the risk of VBI, especially among young and middle-aged patients. Understanding these patterns aids in accurate diagnosis and targeted management of VBI.
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