Tehran University Medical Journal

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Background: Vertebrobasilar dolichoectasia is defined as a prominent elongation, dilatation and tortuosity of the vertebral and basilar arteries. Ectatic basilar arteries may cause different neurological symptoms by several mechanisms including compressive effects and embolic or ischemic events.

Case presentation: In this report we present a 58-year old female patient who was admitted in Dr. Shariati General Hospital in Tehran, Iran with complaints of dysarthria, vertigo, ataxia and nausea. Neuro-imaging procedures (brain CT scan, CT angiography, and an MRI study of the blood vessels or MRA) were performed. Dilation and elongation, as well as tortuosity of the vertebral and basilar arteries revealed the diagnosis of vertebrobasilar dolichoectasia. The patient was discharged from the hospital following the control of underlying diseases and neurological symptoms related to dolichoectasia without undergoing any invasive procedures.

Conclusion: Paying attention to any minor or major neurological symptoms, as well as underlying medical conditions along with the conservative control of symptoms can be most helpful. Invasive interventions in a chronically ill patient can be very risky, therefore, medical management including control of associated or underlying diseases is recommended as the first line of treatment.

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Background: Nonalcoholic Fatty Liver Disease (NAFLD) is one of the most wide-spread human diseases that can impair liver function and sometimes progresses to cir-rhosis. Recently NAFLD has been identified as an independent risk factor for cardio-vascular disease. The aim of this study was to investigate the correlation of fatty liver disease and its sonographic severity on the resistance of the intracranial arteries. Methods: This study was a cross-sectional study of 55 patients referred from Gastroen-trology clinic with diagnosis of NAFLD to Sonodoppler department of Iranian Center of Neurological Research. Pulsaltile index as a Hemodynamic parameter of Middle Cerebral (MCA) and basilar Arteries of NAFLD Patients was measured by Trans Cra-nial Doppler (TCD) sonography and the measurements were compared with normal values. Also the association of these indices with serum liver enzymes and sonographic grading of liver involvement was assessed. The analysis was done by SPSS 16. Fre-quency distribution, mean and standard deviation were used in descriptive analysis and statistical test 2 to compare qualitative variables. Results: Pulsatile Index (PI) were normal (MCA, P= 0.166, Basilar, P= 0.053) and there was no significant difference with relation to severity of fatty liver based on so-nography findings (P= 0.789), but serum liver enzyme levels were inversely correlated with basilar artery PI (P= 0.014). Conclusion: Considering the increase of cerebral arteries PI in advanced liver disease, absence of increase in vascular PI of patients in the present study could be attributed to the short duration of disease from diagnosis to perform TCD, lack of advanced liver involvement (absence of liver dysfunction) and the response effect to treatment before the TCD. Therefore, to assess vascular changes over time, repeating the TCD with assess other parameters such as Fibroscan and K18 factor that has more compatibility of liver function, could help to understand the pathophysiology of liver diseases and its effect on vascular resistance.