Unilateral Sensorineural Hearing Loss Associated With Vertebrobasilar Dolichoectasia
Vertebrobasilar dolichoectasia (VBD) is a rare arteriopathy defined as expansion, elongation, and/or increased tortuosity of the vertebrobasilar arteries. This disease has a complex and, as yet, incompletely described pathophysiology. Hypertension and atherosclerotic changes, congenital abnormalities, and upregulation of certain matrix metalloproteinases are associated with an increased incidence of VBD. Common to all VBD patients is disruption of the internal elastic lamina of the dolichoectatic vessel (1). VBD is more common in males and is overwhelmingly seen in patients older than 50, unless a congenital etiology is present (1). Radiographically, VBD is diagnosed using Smoker's criteria which include: 1) vertebrobasilar artery diameter more than 4.5 mm, 2) deviation of any point of the artery more than 10 mm from its expected course, and 3) length of basilar artery more than 29.5 mm or length of the intracranial vertebral artery more than 23.5 mm (2,3).