2,355 results match your criteria Vertebrobasilar Stroke


Interobserver Agreement in Scoring Angiographic Results of Basilar Artery Occlusion Stroke Therapy.

AJNR Am J Neuroradiol 2021 Jun 11. Epub 2021 Jun 11.

Department of Interventional Neuroradiology (Francis Turjman), Hospices Civils de Lyon, Lyon,France.

Background And Purpose: The modified TICI Infarction grading system is a metric currently used to evaluate angiographic results of thrombectomy for large-vessel occlusion in ischemic stroke. Originally designed for evaluating MCA territories, it is currently used for other vessel occlusions, including the posterior circulation. We postulate that the modified TICI use for the posterior circulation is not accurate due to the different vascular territories supplied by vertebrobasilar vasculature, making grading more complex. Read More

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Predictors of mortality for acute vertebrobasilar artery occlusion receiving endovascular treatment.

Acta Neurol Scand 2021 Jun 8. Epub 2021 Jun 8.

Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China.

Objectives: Acute vertebrobasilar artery occlusion (VBAO) is a devastating type of stroke with a high mortality rate. This study aimed to investigate the predictors of 3-month and 1-year mortality in VBAO patients receiving endovascular treatment (EVT).

Materials & Methods: Consecutive acute VBAO patients undergoing EVT between January 2014 and December 2019 were retrospectively analyzed in a prospectively maintained database. Read More

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Bilateral Vertebral Artery Vasculitis-A Rare Manifestation of Giant Cell Arteritis and a Difficult Diagnosis Made Possible by 2-[F]FDG PET/CT.

Diagnostics (Basel) 2021 May 14;11(5). Epub 2021 May 14.

Department of Ophthalmology, Rigshospitalet, University of Copenhagen, 2600 Glostrup, Denmark.

Giant cell arteritis (GCA) is the most common form of large vessel vasculitis. GCA is a medical and ophthalmological emergency, and rapid diagnosis and treatment with high-dose corticosteroids is critical in order to reduce the risk of stroke and sudden irreversible loss of vision. GCA can be difficult to diagnose due to insidious and unspecific symptoms-especially if typical superficial extracranial arteries are not affected. Read More

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Free-floating and spinning thrombus of the basilar artery: A case report.

Medicine (Baltimore) 2021 May;100(21):e25696

Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.

Rationale: Free-floating thrombi in the intracranial artery are rare. We report a case of a free-floating and spinning thrombus caused by turbulent flow distal to the basilar artery stenosis. We compare thrombus changes in a series of images according to time and describe the approach to treatment and thrombosis resolution. Read More

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Impact of revascularization therapies on outcome of posterior circulation ischemic stroke: The Indo-US stroke project.

J Neurol Sci 2021 May 18;427:117499. Epub 2021 May 18.

Department of Neurology, Stroke Service, Massachusetts General Hospital, Boston, USA.

Introduction: Posterior circulation strokes (PCS) have been less extensively studied than anterior circulation strokes (ACS), especially regarding revascularization therapies. We analyzed the differences in baseline stroke characteristics, revascularization therapy and 3-month outcomes between PCS and ACS in a large prospective multicentre Indian stroke registry.

Methods: Patients with acute ischemic stroke recruited in the Indo-US collaborative stroke project from January 2012 to August 2014 were classified into PCS and ACS based on imaging-confirmed infarct location. Read More

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Frequency, Determinants, and Outcomes of Emboli to Distal and New Territories Related to Mechanical Thrombectomy for Acute Ischemic Stroke.

Stroke 2021 May 20:STROKEAHA120033377. Epub 2021 May 20.

Department of Neurology, UCLA, Los Angeles, CA. (D.L., M.N., L.S., N.R., J.H., S.S., J.L.S.).

Background And Purpose: Clot fragmentation and distal embolization during endovascular thrombectomy for acute ischemic stroke may produce emboli downstream of the target occlusion or in previously uninvolved territories. Susceptibility-weighted magnetic resonance imaging can identify both emboli to distal territories (EDT) and new territories (ENT) as new susceptibility vessel signs (SVS). Diffusion-weighted imaging (DWI) can identify infarcts in new territories (INT). Read More

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Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion.

N Engl J Med 2021 05;384(20):1910-1920

From the Departments of Radiology (L.C.M.L., E.J.R.J.H., J.-A.V.) and Neurology (W.J.S.), St. Antonius Hospital, Nieuwegein, the Departments of Neurology (D.W.J.D.) and Radiology and Nuclear Medicine (A.L., P.-J.D.), Erasmus University Medical Center, Rotterdam, the Departments of Radiology (R.T.H.L.) and Neurology (L.J.K.) and the Department of Neurology and Neurosurgery, Brain Center, and the Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, and Utrecht University (A.A.), Utrecht, the Departments of Neurology (J.B.) and Radiology (G.J.L.N.), Haaglanden Medical Center, and the Department of Neurology, Haga Hospital (K.F.L.), The Hague, the Departments of Neurology (J.S.) and Radiology and Nuclear Medicine (W.H.Z.), Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Departments of Neurology (P.J.N.) and Radiology (C.B.L.M.M., B.J.E.), Amsterdam University Medical Center, Amsterdam, the Department of Neurology, Rijnstate Hospital, Arnhem, and the Department of Clinical Neurophysiology, University of Twente, Enschede (J.H.), the Departments of Neurology (M.J.H.W.) and Radiology (A.C.G.M.E.), Leiden University Medical Center, Leiden, and the Department of Neurology, Amphia Hospital, Breda (M.J.M.R.) - all in the Netherlands; the Interventional Neuroradiology Service (F.J.A.M.) and the Neurology Service (J.J.F.C., F.O.L.), Hospital Geral de Fortaleza, Fortaleza, the Department of Neurology, Federal University of Rio Grande do Sul and Hospital de Clinicas de Porto Alegre, Porto Alegre (S.O.M.), and the Stroke Service, Neurology Division, Department of Neuroscience and Behavioral Sciences (F.A.D., O.M.P.-N.), and the Interventional Neuroradiology Service, Department of Medical Imaging, Hematology and Oncology (D.G.A.), Ribeirão Preto Medical School, University of São Paulo, São Paulo - all in Brazil; the Institute of Neuroradiology (J.C.G.) and the Department of Neurology (V.P.), Dresden Neurovascular Center, University Hospital Carl Gustav Carus, and Medizinische Fakultät Carl Gustav Carus (H.S.), Technische Universität Dresden, Dresden, the Department of Neurology and Center for Stroke Research, Charité Universitätsmedizin Berlin, Berlin (C.H.N., H.J.A.), the Department of Neurology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim (K.S.), the Department of Neurology, University Hospital Augsburg, Augsburg (H.S.), and the Department of Neurology, Oberschwabenklinik, Ravensburg (C.M.R.) - all in Germany; Rothschild Foundation Hospital, INSERM Unité 1148, University of Paris, Paris (M.M., M.P.); the IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center, Maggiore Hospital, Bologna (A.Z.), and the Neuroradiology Unit, Department of Neuroscience, Ospedale Civile S. Agostino-Estense, Modena University Hospital, Modena (S.V.) - both in Italy; the Texas Stroke Institute, Fort Worth (A.J.Y.); and the Stroke Center, Neurology Service, Lausanne University Hospital, Lausanne, Switzerland (P.M.).

Background: The effectiveness of endovascular therapy in patients with stroke caused by basilar-artery occlusion has not been well studied.

Methods: We randomly assigned patients within 6 hours after the estimated time of onset of a stroke due to basilar-artery occlusion, in a 1:1 ratio, to receive endovascular therapy or standard medical care. The primary outcome was a favorable functional outcome, defined as a score of 0 to 3 on the modified Rankin scale (range, 0 to 6, with 0 indicating no disability, 3 indicating moderate disability, and 6 indicating death) at 90 days. Read More

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The efficacy and risk factors of mechanical thrombectomy for the treatment of vertebrobasilar artery occlusion: a single center study.

Ann Palliat Med 2021 Apr;10(4):4697-4704

Department of Neurology, Taixing People's Hospital, Taixing, China.

Background: The mortality of acute ischemic stroke patients caused by vertebrobasilar artery occlusion (VBAO) is high and mechanical thrombectomy has gradually become a promising treatment for acute ischemic stroke. This study analyzed the efficacy of mechanical thrombectomy and the risk factors associated with poor outcomes in VBAO patients caused by severe local atherosclerotic stenosis.

Methods: This retrospective study enrolled patients with acute ischemic stroke caused by VBAO between March 1, 2016 and August 31, 2019. Read More

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[Stenting of the first segment of the spinal artery in the acutest period of ischemic stroke in the vertebrobasilar territory].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(3. Vyp. 2):38-45

Kuban State Medical University, Krasnodar, Russia.

Objective: To analyze hospital and long-term results of stenting of the V1 segment of the vertebral artery (VA) in the first hours after acute cerebral hemopoiesis/transient ischemic attack (stroke/TIA) in the vertebrobasilar territory (VT).

Material And Methods: The current retrospective study from 2012 to 2019 included 169 patients with hemodynamically significant stenosis of the V1 segment of the VA, who underwent emergency stenting in the first hours after the onset of stroke. The mean time between the development of stroke and correction was 368. Read More

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Transient Vestibular Symptoms Preceding Posterior Circulation Stroke: A Prospective Multicenter Study.

Stroke 2021 Jun 27;52(6):e224-e228. Epub 2021 Apr 27.

Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine, Biomedical Research Institute, Busan, South Korea (S.-Y.C., K.-D.C.).

Background And Purpose: The recognition of clinical features of transient vestibular symptoms (TVSs) preceding posterior circulation stroke (PCOS) would be informative to discriminate dizziness/vertigo due to vertebrobasilar transient ischemic attack from the acute transient vestibular syndrome. We sought to determine the prevalence and characteristics of TVSs preceding PCOS.

Methods: We performed a prospective multicenter observational study that had recruited 447 patients with PCOS from referral-based 4 university hospitals in Korea. Read More

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A Pre-Interventional Scale to Predict Atherosclerotic Thrombosis in Acute Vertebrobasilar Artery Occlusion Patients.

Front Neurol 2021 7;12:648081. Epub 2021 Apr 7.

Department of Neurology, Jinling Hospital, Medical School of Southeast University, Nanjing, China.

Determining the occlusion mechanism before endovascular treatment (EVT) is of great significance for acute large vessel occlusion patients. We aimed to develop and validate a simple pre-EVT scale with readily available variables for predicting atherosclerotic thrombosis (ISAT) in acute vertebrobasilar artery occlusion (VBAO) patients. Consecutive patients were retrieved from Nanjing Stroke Registry Program between January 2014 and December 2019 as a derivation cohort. Read More

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Bilateral Vertebral Artery Hypoplasia and Fetal-Type Variants of the Posterior Cerebral Artery in Acute Ischemic Stroke.

Front Neurol 2021 8;12:582149. Epub 2021 Apr 8.

Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan.

Unilateral vertebral artery hypoplasia is considered a risk factor for posterior circulation infarction. Despite the increasing attention on unilateral vertebral artery hypoplasia, few studies have discussed bilateral vertebral artery hypoplasia, its influence on stroke, or its collateral supply from the circle of Willis. We aimed to identify its characteristics, stroke pattern, and unique ultrasonographic and brain imaging findings. Read More

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Acute Dizziness, Vertigo, and Unsteadiness.

Neurol Clin 2021 05 30;39(2):373-389. Epub 2021 Mar 30.

Department of Neurology, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 1805, USA; Tufts University School of Medicine, Burlington, MA, USA.

Vestibular symptoms, including dizziness, vertigo, and unsteadiness, are common presentations in the emergency department. Most cases have benign causes, such as vestibular apparatus dysfunction or orthostatic hypotension. However, dizziness can signal a more sinister condition, such as an acute cerebrovascular event or high-risk cardiac arrhythmia. Read More

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Relationship of brainstem infarction to rupture of nonsaccular vertebrobasilar aneurysms.

J Neurosurg 2021 Apr 23:1-7. Epub 2021 Apr 23.

Departments of1Neurosurgery.

Objective: Symptomatic nonsaccular vertebrobasilar aneurysms (NSVBAs) are associated with high rates of aneurysm-related death. Anecdotal evidence suggests that brainstem infarction may be a harbinger of aneurysm rupture. The authors aimed to investigate the association between brainstem infarction and subsequent NSVBA rupture. Read More

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Cerebellar artery infarction with sudden hearing loss and vertigo as initial symptoms: A case report.

World J Clin Cases 2021 Apr;9(11):2519-2523

Department of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China.

Background: Sudden hearing loss (SHL) is associated with serious systematic conditions such as neoplasms, vascular events, autoimmune diseases, infections, and iatrogenic injury. Some authors report that SHL can be an early warning sign of impending vertebrobasilar ischemic stroke. It is important to distinguish stroke from benign disease. Read More

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Fusion for subaxial bow hunter's syndrome results in remote osseous remodeling of the hyperostotic growth responsible for vertebral artery compression.

Surg Neurol Int 2021 17;12:104. Epub 2021 Mar 17.

Department of Neurosurgery, Naval Medical Center San Diego, San Diego, California, United States.

Background: The authors present a previously unreported case of a patient with diffuse idiopathic skeletal hyperostosis (DISH) who developed bow hunter's syndrome (BHS) or positional vertebrobasilar insufficiency. In addition, the authors demonstrate angiographic evidence of remote osseous remodeling after segmental fusion without direct decompression of the offending bony growth. BHS is a rare, yet well established, cause of posterior circulation ischemia and ischemic stroke. Read More

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General anesthesia versus monitored anesthesia care during endovascular therapy for vertebrobasilar stroke.

Am J Transl Res 2021 15;13(3):1558-1567. Epub 2021 Mar 15.

The First Clinical College of Southern Medical University Guangzhou, Guangdong Province, China.

Objective: The objective is to compare the effect of general anesthesia (GA) and monitored anesthesia care (MAC) on clinical outcomes in patients with endovascular therapy for vertebrobasilar occlusion stroke.

Methods: 139 patients undergoing endovascular therapy for vertebrobasilar stroke, were recruited. The patients were randomized into GA group and MAC group (about 1:1 ratio). Read More

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Cervical duplex ultrasound for the diagnosis of giant cell arteritis with vertebral artery involvement.

J Neuroimaging 2021 Apr 5. Epub 2021 Apr 5.

Second Department of Neurology, National & Kapodistiran University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece.

Giant cell arteritis (GCA) is a systemic inflammatory arteriopathy of medium and large-sized arteries, predominantly affecting branches of the external carotid artery. Ischemic stroke has been reported in 2.8-7% of patients diagnosed with GCA. Read More

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Ischemic Cerebellar Stroke in a 4-Year-Old Boy After Chickenpox: An Atypical Vascular Involvement.

J Stroke Cerebrovasc Dis 2021 Jun 1;30(6):105719. Epub 2021 Apr 1.

Child Development Centre, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Electronic address:

Cerebrovascular events in pediatric population are very rare. Up to 30% may result from varicella zoster (VZV) arteriopathy, usually as a delayed complication of varicella primary infection. The most typical pattern includes involvement of anterior brain circulation arteries, probably by VZV migration from the trigeminal ganglia. Read More

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Introducing Adam's Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes.

Brain Sci 2021 Mar 26;11(4). Epub 2021 Mar 26.

Department of Neurological and Neurosurgical Nursing, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-821 Bydgoszcz, Poland.

Background: Assessing the severity of posterior circulation strokes, due to the variety of symptoms, is a significant clinical problem. Current clinimetric scales show lower accuracy in the measurement of posterior stroke severity, compared with that of anterior strokes. The aim of the study was to design a validated tool, termed Adam's Scale of Posterior Stroke (ASPOS), for better assessment and prediction of posterior stroke. Read More

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Endovascular treatment of acute basilar artery occlusion: Outcomes, influencing factors and imaging characteristics from the Tama-REgistry of acute thrombectomy (TREAT) study.

J Clin Neurosci 2021 Apr 8;86:184-189. Epub 2021 Feb 8.

Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan.

Objective: The effectiveness of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) remains unknown. We evaluated the feasibility, safety, and efficacy of endovascular treatment for ABAO.

Methods: We retrospectively investigated patients with ABAO who underwent MT using modern stent retrievers and an aspiration device between January 2015 and March 2019 at 12 comprehensive stroke centers. Read More

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Association between the vertebrobasilar artery geometry and basilar artery plaques determined by high-resolution magnetic resonance imaging.

BMC Neurosci 2021 03 25;22(1):20. Epub 2021 Mar 25.

Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China.

Background: Atherosclerotic plaques are often present in regions of arteries with complicated flow patterns. Vascular morphology plays important role in hemodynamics. In this study, we investigated the relationship between the geometry of the vertebrobasilar artery system and presence of basilar artery (BA) plaque. Read More

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A novel angiographic classification for the endovascular recanalization of symptomatic nonacute extracranial vertebral artery occlusion.

J Neurointerv Surg 2021 Mar 15. Epub 2021 Mar 15.

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China.

Background: There remains major uncertainty regarding the optimal therapy for symptomatic nonacute extracranial vertebral artery occlusion (EVAO). Endovascular recanalization for EVAO is technically challenging, and limited data are available. This research aimed to report a multicenter clinical experience of endovascular recanalization for symptomatic nonacute EVAO and establish a novel angiographic classification. Read More

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Endovascular recanalization for non-acute basilar artery occlusions with progressive or recurrent ischemic symptoms: a multicenter clinical experience.

J Neurointerv Surg 2021 Mar 4. Epub 2021 Mar 4.

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Background: There is no consensus on the optimal treatment of non-acute basilar artery occlusion (BAO), and endovascular recanalization still poses a therapeutic challenge for these patients. We report a multicenter clinical experience of endovascular recanalization for symptomatic non-acute BAO and propose an angiographic grouping to determine which patient subgroup most benefits from this treatment.

Methods: Forty-two patients with non-acute BAO with progressive or recurrent vertebrobasilar ischemic symptoms who underwent endovascular recanalization were retrospectively analyzed from January 2015 to December 2019. Read More

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Stenting for Symptomatic Intracranial Vertebrobasilar Artery Stenosis in Northeast of China: A Single-Center Study.

Front Neurol 2020 16;11:609286. Epub 2021 Feb 16.

Department of Neurology, Stroke Center & Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Changchun, China.

We described the incidence of surgery-related complications to evaluate the safety of endovascular therapy for severe symptomatic intracranial vertebral basilar artery stenosis (IVBS) in our stroke center in Northeast of China. Consecutive patients with symptomatic IVBS caused by 70-99% stenosis despite standard medical treatment of antiplatelet agents plus statin were enrolled. Either balloon-mounted stent or balloon predilation plus self-expanding stent was performed. Read More

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February 2021

Basilar artery occlusion presenting as sudden bilateral deafness: a case report.

J Med Case Rep 2021 Mar 2;15(1):111. Epub 2021 Mar 2.

Department of Neurosurgery, Tokushima Municipal Hospital, 2-34, Kitajyosanjima-cho, Tokushima, 770-0812, Japan.

Background: Most sudden-onset hearing loss is due to otolaryngologic- and very rarely to cerebrovascular disease. We report a woman with sudden bilateral sensorineural hearing loss. This case suggests that even in the absence of brainstem or cerebellar signs, magnetic resonance imaging (MRI) and MR angiography (MRA) should be performed since such studies may reveal signs of life-threatening vertebrobasilar artery occlusion. Read More

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Life Support Limitations in Mechanically Ventilated Stroke Patients.

Crit Care Explor 2021 Feb 22;3(2):e0341. Epub 2021 Feb 22.

Université de Paris, UMR 1137, IAME, Paris, France.

Objectives: The determinants of decisions to limit life support (withholding or withdrawal) in ventilated stroke patients have been evaluated mainly for patients with intracranial hemorrhages. We aimed to evaluate the frequency of life support limitations in ventilated ischemic and hemorrhagic stroke patients compared with a nonbrain-injured population and to determine factors associated with such decisions.

Design: Multicenter prospective French observational study. Read More

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February 2021

Modified Sternocleidomastoid Sparing Approach for Vertebral Artery (V1) to Common Carotid Artery Transposition: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 05;20(6):E448

Division of Neurosurgery, University of Missouri, Columbia, Missouri, USA.

Vertebral artery (VA) V1 segment to common carotid artery (CCA) transposition is an uncommon operation with existing literature describing dissection of the sternoclavicular head of the sternocleidomastoid (SCM) muscle.1,2 We present a modified approach for transposition without cutting the SCM. Our patient is a 76-yr-old female with history of a previous cerebellar stroke. Read More

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Impact of the Perioperative Blood Pressure on Clinical Outcome after Thrombectomy in Acute Basilar Artery Occlusion.

J Stroke Cerebrovasc Dis 2021 Mar 9;30(3):105590. Epub 2021 Jan 9.

Neurointervention Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. Electronic address:

Aim: Optimal blood pressure (BP) management in vertebrobasilar circulation stroke patients undergoing thrombectomy remains undetermined. We aimed to evaluate the impact of perioperative BP on clinical outcome after MT in acute basilar artery occlusion (BAO) patients.

Methods: We retrospectively analyzed all consecutive patients hospitalized with acute basilar artery occlusion administered endovascular treatment within 24 h from January 2012 to July 2018 in Beijing Tiantan Hospital. Read More

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