A clinical study of 135 patients with cerebral vascular fenestrations

Objective To characterize the imaging features of cerebral vascular fenestrations and the clinical features of patients with cerebral infarction. Methods We retrospectively analyzed the magnetic resonance or CT imaging data of 135 cases of cerebral vascular fenestrations from January 2015 to July 2017 in the First Affiliated Hospital of Fujian Medical University. The location, morphology and the other associated vascular diseases were described. The patients who had cerebral infarction were also analyzed. Results One hundred and thirty-five fenestrations were noted at our institution, 129 in arteries, and six in veins, the detection rate being 1.1%(135/12 232). Basilar arteries were most common, which accounted for 53.3% (72/129) of the fenestrations. Twenty-eight (20.7%) of these patients had other vascular malformations, with a total of 15 aneurysms, two moyamoya diseases, five venous malformations, two arteriovenous fistulas, and four cavernous hemangiomas. Nine patients had cerebral infarctions, of which five patients had fenestration-relevant cerebral infarctions, and no risk factors for cerebral infarctions were found except fenestration in one patient who was diagnosed with cryptogenic stroke. No acute cerebral infarctions or transient ischemic attack occurred in patients with fenestration-relevant cerebral infarctions who had long-term antiplatelet and statin therapy during follow-up. Conclusions Cerebral vascular fenestrations occur most frequently in the basilar artery and may combine with other malformations. Long-term antiplatelet and statin therapy can be used for cerebral infarctions patients with cerebral vascular fenestrations. Key words: Central nervous system vascular malformations; Stroke; Magnetic resonance imaging