According to previous studies, Fabry diagnosis should be considered in female patients with asymmetric, confluent white matter lesions on MRI without or with very mild corpus callosum T1 hyperintensities and/or lack of gadolinium enhancement and/or normal spinal MRI, ectatic vertebrobasilar arteries
, and/or negative oligoclonal bands, significant proteinuria or unexplained left ventricular hyperthrophy, and a relative that died at a young age from unspecified renal, cardiac or cerebro-vascular disease (X-linked) (10,11).
The offending vessels leading to compression are mostly elongated, expanded, hardened, tortuous vertebrobasilar arteries
. In some cases, facial nerve roots even have impressions, being concomitant with local attenuation and color changes.9 In this study, we followed up 106 of 415 patients with delayed healing after MVD, and analyzed their clinical data, aiming to determine the related factors.
PPTA is a temporary embryonic vascular anastomosis between the carotid and vertebrobasilar arteries
, with a reported incidence of 0.03–2.20%.[sup] There is a female sex predilection, and it may occur in patients of any age.[sup] PPTA generally causes no specific symptoms and occasionally presents with other cerebrovascular variants.[sup] Only 14 patients with anastomosis in association with moyamoya disease have been reported, with initial symptoms mainly caused by cerebrovascular diseases.[sup], Our case was diagnosed as a transient ischemic attack based on clinical symptoms and cranial MRI, most likely caused by low cerebral blood perfusion due to moyamoya disease.
The cases with occlusion, stenosis, or aneurysm in main vertebrobasilar arteries
and also the cases with acute or chronic infarcts in areas supplied by the posterior circulation such as cerebellum, brainstem, or occipital lobes (n = 31) are excluded.
Irreversible events--which are very rare but have led to cases of paralysis and death--include cauda equina syndrome, which sometimes can be reversed with prompt surgery, and vascular injury, primarily to the vertebrobasilar arteries