Dolichoectatic basilar artery
Dolichoectatic basilar artery (DBA) is a rare medical condition that affects the basilar artery, which is a major blood vessel in the brain that supplies oxygen-rich blood to the brainstem and other structures in the brain. In DBA, the basilar artery becomes abnormally enlarged, twisted, and tortuous, resembling a corkscrew or a serpent.
DBA is often asymptomatic, meaning that it does not cause any symptoms or health problems in many people who have it. However, in some cases, DBA can lead to neurological symptoms, such as vertigo, dizziness, double vision, facial numbness, hearing loss, tinnitus, difficulty swallowing, slurred speech, and weakness or paralysis on one side of the body. DBA can also increase the risk of ischemic stroke, hemorrhagic stroke, or brainstem compression.
DBA is typically diagnosed using imaging tests, such as magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), computed tomography (CT) angiography, or digital subtraction angiography (DSA). Treatment options for DBA depend on the severity of the condition and the presence of symptoms. In many cases, DBA does not require any specific treatment, and the focus is on managing the symptoms and reducing the risk of stroke. Treatment options may include medications, such as aspirin or anticoagulants, or surgical interventions, such as stenting or clipping. It is important for people with DBA to have regular follow-up appointments with their healthcare providers to monitor the condition and prevent complications.
Kawase Approach for “Macrovascular” Decompression of Dolichoectatic Basilar Artery Causing Hemifacial Spasm Using Gore-tex Sling 1).
The treatment for DBA-causing HFS is decompression of the affected nerve. One surgical technique used for this is the placement of a Gore-tex sling around the affected nerve to prevent its compression by the dilated and elongated blood vessel. The Gore-tex sling is a flexible material that is wrapped around the nerve to provide a protective barrier and to prevent further compression by the artery.
The surgery involves exposing the affected nerve and carefully placing the Gore-tex sling around it. The goal is to create a space between the nerve and the artery, allowing the nerve to function normally again and alleviate the symptoms of HFS. The success rate of this procedure is high, with many patients experiencing complete resolution of their HFS symptoms.
It's important to note that this surgery is considered a complex procedure and is typically performed by highly skilled neurosurgeons with experience in treating DBA and related conditions. As with any surgery, there are potential risks and complications, and it's important to discuss these with your doctor and make an informed decision about whether this procedure is right for you.