hypoplastic left vertebral artery

I am a 57 year old male with recently diagnosed type 2 diabetes (controlled) and mild hypetension (controlled) and am generally in good health.  In 2005 I awoke with acute dizziness which was ultimately diagnosed and treated as BPPV.  This spring once again I experienced actue dizziness.vertigo upon awaking and subsequently undergone a complete ENG test (all results were negative) after which I was referred to neurology for further tests.

I was given an MRI/MRA which indicated some hypoplasia of my left vertral artery.  My doctor asked that I start taking 325mg asprin daily and return for a second MRI/MRA in six months.  The nerologis said I was at no risk of stroke in his view but indicated that he felt continued vigilance was warranted.

I continue to have undiagnosed dizziness which both specialists indicate is non-specific and undiagnosed.  

I have signficiant stroke family history so am sensitive to the potential of a future stroke due to this condition.  Should I seek alternative opinions and more aggressive treatment?


My family history includes stroke risk.  

[sonu78]

Hi,
Your dilemma is understandable.
When you have hypoplasia of left vertebral artery, the other counterpart usually compensates for that. But still the compensation may not be 100%.
Since your a known diabetic, you may develop atherosclerotic condition  little earlier, which may further have an effect on your blood vessels.
But overall just an hypoplastic left vertebral artery cannot put you into high risk for stroke.
You require to be on a strict follow up.
Do also have a second opinion.

[Abhijeet Deshmukh, MD]

Hi.

You are correct in saying that you have a risk of stroke. And this is not only due to the family history. The hypoplasia of your left vertral artery puts you in a risk for stroke in the posterior circulation area. We have a few good references for this. You must get regular scans (MRAs) of the blood vessels.

In your case, it will help to know if your posterior communicating arteries exist and working. If they are absent, there is an increased risk.

Also, if you mean surgery, when you say more aggressive treament, it is not advised.
But do follow a proper drug regimen.

All the best.

DrAbhijeetMD