{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:45:18Z","timestamp":1786124718775,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2018,12,27]],"date-time":"2018-12-27T00:00:00Z","timestamp":1545868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Vertebrobasilar artery dolichoectasia may result in neural element compression anywhere along its course within the cervical region, the craniocervical junction or in the posterior fossa. The clinical syndromes most often observed include cranial neuropathy, bulbar dysfunction, myelopathy and cervical radiculopathy. When indicated, the operative techniques utilized to address vertebrobasilar artery dolichoectasia must be individually tailored, can be technically challenging, and have been rarely expounded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To share selected cases that demonstrate the variety of pathological states caused by vertebrobasilar artery dolichoectasia as well as our experience in managing this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Here we review examples of pathological impingement of neural elements compressed by ectasia within the vertebrobasilar arterial system throughout its anatomic course. The surgical techniques we have employed to alleviate the compression, including simple decompression as well as sling-assisted arterial transposition, are described. The evolution and refinement of our transposition technique are detailed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A wide range of pathological conditions may result from compression of neural structures throughout the course of the vertebrobasilar system. Compression of cervical nerve roots, the spinal cord, brainstem, and cranial nerves can be seen. Microsurgical management may be indicated in selected cases with gratifying results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Pathological compression of neural structures throughout the course of the vertebrobasilar system should be recognized. When indicated, microsurgical decompression must be tailored to the individual symptomology and the unique anatomic relationship in each case with the potential to prevent neurological worsening and, in many cases, improve functional outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opy391","type":"journal-article","created":{"date-parts":[[2018,12,27]],"date-time":"2018-12-27T00:48:33Z","timestamp":1545871713000},"page":"481-490","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Microsurgical Strategies for the Treatment of Compression Neuropathies Secondary to Vertebrobasilar Dolichoectasia: From Simple Decompression to Sling Transposition"],"prefix":"10.1227","volume":"17","author":[{"given":"Daniel L","family":"Barrow","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lenox Hill Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,11]]},"reference":[{"issue":"4 Suppl","key":"bib1-20240909","first-page":"262","article-title":"Anterolateral approach to the V2 segment of the vertebral artery","volume":"57","author":"Bruneau","year":"2005","journal-title":"Neurosurgery"},{"issue":"3","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s11936-011-0123-z","article-title":"Dolichoectasia of the intracranial arteries","volume":"13","author":"Kwon","year":"2011","journal-title":"Curr Treat Options Cardio Med"},{"issue":"1","key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.04.003","article-title":"Clinicoradiologic features of vertebrobasilar dolichoectasia in stroke patients","volume":"21","author":"Nakamura","year":"2012","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"12","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"4171","DOI":"10.1007\/s00586-016-4691-1","article-title":"Vertebral artery loops in surgical perspective","volume":"25","author":"Eksi","year":"2016","journal-title":"Eur Spine J"},{"issue":"1 Suppl","key":"bib5-20240909","first-page":"117","article-title":"Bulbar compression by an ectatic vertebral artery: a novel neurovascular construct relieved by microsurgical decompression","volume":"56","author":"Tomasello","year":"2005","journal-title":"Neurosurgery"},{"issue":"1","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1136\/jnnp.45.1.29","article-title":"The clinical picture of ectasia of the intracerebral arteries","volume":"45","author":"Yu","year":"1982","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"2","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/00000658-198508000-00018","article-title":"Neurogenic hypertension: etiology and surgical treatment. 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Observations in an experimental nonhuman primate model","volume":"202","author":"Jannetta","year":"1985","journal-title":"Ann Surg"},{"issue":"4","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1212\/WNL.24.4.301","article-title":"Clinical significance of basilar artery aneurysms","volume":"24","author":"Nijensohn","year":"1974","journal-title":"Neurology"},{"issue":"4","key":"bib9-20240909","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s10143-017-0812-5","article-title":"Microvascular decompression is an effective therapy for trigeminal neuralgia due to dolichoectatic basilar artery compression: case reports and literature review","volume":"40","author":"Apra","year":"2017","journal-title":"Neurosurg Rev"},{"issue":"1","key":"bib10-20240909","doi-asserted-by":"crossref","first-page":"153","DOI":"10.4103\/2152-7806.122397","article-title":"Dolichoectasia of the vertebral basilar and internal carotid arteries: a case report and literature review","volume":"4","author":"Yuh","year":"2013","journal-title":"Surg Neurol Int"},{"issue":"1","key":"bib11-20240909","doi-asserted-by":"crossref","first-page":"20","DOI":"10.4103\/2152-7806.127379","article-title":"Dolichoectasia of the vertebrobasilar complex causing neural compression","volume":"5","author":"Grasso","year":"2014","journal-title":"Surg Neurol Int"},{"issue":"4","key":"bib12-20240909","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.4081\/cp.2012.e84","article-title":"The dilemma of treating vertebrobasilar dolichoectasia","volume":"2","author":"Lin","year":"2012","journal-title":"Clin Pract"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/17\/5\/481\/30092171\/opy391.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opy391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:44:42Z","timestamp":1786121082000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opy391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,27]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opy391","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,27]]},"assertion":[{"value":"2018-05-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}