Background And Introduction: Patients presenting with posterior circulation acute ischemic events are occasionally noted to have occlusion of bilateral vertebral arteries with basilar artery blood flow entirely dependent from the anterior circulation. There is limited data about prognosis of such patients in literature.
Methods: Patients with acute posterior circulation ischemic stroke and bilateral vertebral artery occlusion (including contra-lateral hypoplastic vertebral artery without contribution to the basilar artery system) were identified prospectively from two academic centers. Data including clinical presentation, medical management, angiographic findings, recurrent events and outcome were collected and reported.
Results: A total of 4 patients presenting with acute ischemic events in the posterior circulation were identified to have bilateral vertebral artery occlusion at our center. One additional patient had a vertebral artery occlusion and a contra-lateral hypoplastic vertebral artery. In the functional evaluation of the blood flow with catheter angiography, the basilar artery was filling from the anterior circulation, with no antegrade flow from bilateral vertebral arteries injection in all 5 patients. Patients were treated with anti-platelets (n=4) or started on anti-coagulation after failing anti-platelet therapy (n=2). All patients had recurrent ischemic stroke with new ischemic lesions proven by diffusion weighted images on MRI within 2 to 70 days after the initial event.
Conclusion: Patients with acute posterior circulation ischemic stroke and bilateral vertebral artery occlusion are at high risk of having early recurrent ischemic events. Reestablishment of the antegrade vertebro-basilar blood flow through endovascular re-canalization might be an option to decrease stroke recurrence in selected patients with acute posterior circulation stroke and bilateral vertebral artery occlusion.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3317285 | PMC |
Publication Analysis
Top Keywords
Similar Publications
Granulomatosis with polyangiitis with cardiac and large vessel involvement: a case report with a constellation of rare complications.
Eur Heart J Case Rep
January 2025
Department of Cardiology, Christian Medical College, New Arcot Road, Vellore 632517, India.
Background: Granulomatosis with polyangiitis (GPA) is an autoimmune multisystem disorder characterized by small vessel vasculitis with granulomatous inflammation. In this report, we describe a unique case of GPA who presented with complete heart block (CHB) and developed complications due to intracranial large vessel involvement.
Case Summary: A 47-year-old gentleman presented with CHB with a background history of arthralgia and blood-tinged nasal discharge.
Comparative analysis of arterial involvement in predominant cranial and isolated extracranial phenotypes of giant cell arteritis using F-FDG PET-CT.
Arthritis Res Ther
December 2024
Department of Rheumatology, Hospital Universitario de Bellvitge. Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
Objective: To investigate differences in arterial involvement patterns on F-FDG PET-CT between predominant cranial and isolated extracranial phenotypes of giant cell arteritis (GCA).
Methods: A retrospective review of F-FDG PET-CT findings was conducted on 140 patients with confirmed GCA. The patients were divided into two groups: the cranial group, which presented craniofacial ischemic symptoms either at diagnosis or during follow-up, and the isolated extracranial group which never exhibited such manifestations.
Replaced right posterior cerebral artery associated with ipsilateral superior cerebellar artery type persistent trigeminal artery variant diagnosed by magnetic resonance angiography.
Surg Radiol Anat
December 2024
Department of Neurosurgery, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Purpose: To describe a case in which a right replaced posterior cerebral artery (PCA) was associated with an ipsilateral superior cerebellar artery (SCA) type persistent trigeminal artery (PTA) variant.
Methods: A 53-year-old man who had been diagnosed with chronic dissection of the left vertebral artery (VA) 4 months previously underwent follow-up magnetic resonance (MR) angiography using a 3-Tesla scanner.
Results: MR angiography showed a slightly dilated left VA at the terminal segment without interval change.
Characteristics and outcomes of subarachnoid hemorrhage from vertebral artery dissection: A comparative study with other non-traumatic etiologies.
Acute Med Surg
December 2024
Department of Emergency, Critical Care, and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan.
Aim: Vertebral artery dissection (VAD) is a rare cause of non-traumatic subarachnoid hemorrhage (SAH) with significant clinical implications. This study compared the clinical characteristics and outcomes of SAH from intracranial VAD rupture to those from other etiologies, primarily aneurysmal rupture.
Methods: This single-center retrospective cohort study at Okayama University Hospital included patients with non-traumatic SAH diagnosed between 2019 and 2023.
Extracranial Vertebral Artery Aneurysm With Neurofibromatosis Type 1: The Effectiveness of Endovascular Intervention.
Cureus
November 2024
Neurosurgery, Shimane University Hospital, Izumo, JPN.
Neurofibromatosis type 1 (NF-1) is associated with vascular complications, including stenosis or the occlusion of the abdominal aorta and renal arteries. However, reports on the occurrence of extracranial vertebral artery aneurysms are scarce. A man in his 40s had back pain and was feeling unwell.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!