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Cerebrovasc Dis 2019 Feb 14;47(1-2):40-47. Epub 2019 Feb 14.

College of Medicine, China Medical University, Taichung, Taiwan.

Background: The natural history of vertebrobasilar artery (VBA) stenosis or occlusion remains understudied.

Methods: Patients with diagnosis of ischemic stroke or transient ischemic attack (TIA) who were noted to have VBA stenosis based on computed tomography or magnetic resonance imaging or catheter-based angiogram were selected from Taiwan Stroke Registry. Cox proportional hazards model was used to determine the hazards ratio (HR) of recurrent stroke and death within 1 year of index event in various groups based on severity of VBA stenosis (none to mild: 0-49%; moderate to severe: 50-99%: occlusion: 100%) after adjusting for differences in demographic and clinical characteristics between groups at baseline evaluation. Read More

Arq Neuropsiquiatr 2019 Jan;77(1):25-32

Universidade Federal de Santa Maria, Departamento de Fonoaudiologia, Santa Maria, RS, Brasil.

Objective: Changes in postural balance and visual complaints are frequent consequences of stroke. We aimed to investigate the symptoms and the vestibular and oculomotor functions of patients with dizziness post ischemic and hemorrhagic stroke and compare the results among them.

Methods: Fifty patients with dizziness after stroke were evaluated through a clinical anamnesis and computerized vector electronystagmography: calibration of ocular movements, spontaneous nystagmus, semi-spontaneous nystagmus, pendular tracking, optokinetic nystagmus, rotary chair testing, and the caloric test. Read More

J Vasc Interv Neurol 2018 Nov;10(2):56-58

Servicio de Neurología del Hospital Universitario Dr. José Eleuterio González de la Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.

Background And Purpose: Cervical artery dissections, which may be traumatic or spontaneous, account for a significant proportion of strokes in the young. Antithrombotic therapy is the mainstay of treatment, but new oral anticoagulants could be an alternative treatment to the optimal strategy of anticoagulation followed by antiplatelet drugs.

Summary Of Case: We report the case of a 40-year-old patient with a spontaneous vertebral artery dissection who developed a cerebellar ischemic stroke, who had a favorable outcome and complete vessel recanalization after three months of treatment with the oral factor Xa inhibitor rivaroxaban. Read More

J Vasc Interv Neurol 2018 Nov;10(2):28-32

Department of Neurosurgery, University of Patras, Patras, Greece.

Background: Hereditary multiple exostoses (HME) is an inherited genetic condition, characterized by the formation of multiple osteochondromas, developing throughout childhood and into puberty. Vascular complications associated with HME are uncommon.

Methods: A case of a patient with HME who was admitted to hospital with subarachnoid hemorrhage (SAH), as a result of acute rupture of a basilar tip aneurysm (BTA), will be presented. Read More

Front Neurol 2018 21;9:1195. Epub 2019 Jan 21.

Department of Neurology, Ajou University Medical Center, Ajou University School of Medicine, Suwon, South Korea.

Differentiation of embolic and atherosclerotic occlusions is difficult prior to endovascular treatment (EVT) of acute ischemic stroke due to intracranial large artery occlusions. CTA-determined occlusion type has been reported to be associated with a negative cardiac embolic source and stent retriever failure, a potential of intracranial atherosclerosis (ICAS)-related occlusions. In this study, we evaluated the agreement between preprocedural identification of CTA-determined truncal-type occlusion (TTO) and postprocedural evaluation of underlying fixed focal stenosis (FFS) in the occlusion site. Read More

Surg Radiol Anat 2019 Feb 7. Epub 2019 Feb 7.

Department of Neurology, Yokohama Brain and Spine Center, 1-2-1 Takigashira, Isogo-ku, Yokohama, 235-0012, Japan.

We report a case of an anomalous anastomosis formed between the external carotid artery (ECA) and the vertebrobasilar artery (VBA) and passing through the hypoglossal canal. A carotid-vertebrobasilar anastomosis of this kind is typically considered a variant of persistent primitive hypoglossal artery which usually originates from the internal carotid artery. However, the anastomotic vessel in this case had a common trunk with the occipital artery (OA), a remnant of the primitive proatlantal artery. Read More

Neurosurg Focus 2019 Feb;46(2):E8

1Department of Neurosurgery, Peking University First Hospital; and.

OBJECTIVESymptomatic steno-occlusion of the proximal vertebral artery (VA) or subclavian artery (ScA) heralds a poor prognosis and high risk of stroke recurrence despite medical therapy, including antiplatelet or anticoagulant drugs. In some cases, the V2 segment of the cervical VA is patent and perfused via collateral vessels. The authors describe 7 patients who were successfully treated by external carotid artery (ECA)-saphenous vein (SV)-VA bypass. Read More

Oxf Med Case Reports 2019 Jan 24;2019(1):omy121. Epub 2019 Jan 24.

Department of Neurosurgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan.

In this report, we describe unilateral medial pontomedullary junction (MPMJ) syndrome as a novel brain stem stroke syndrome. A 68-year-old woman suddenly developed vertigo, ipsilateral facial paresis, contralateral thermal hypoalgesia (TH) and dysphagia without lateral gaze palsy, curtain sign and hoarseness. Magnetic resonance (MR) imaging showed a small infarction at the right MPMJ. Read More

BMC Neurol 2019 Jan 29;19(1):14. Epub 2019 Jan 29.

Department of Neurology, Faculty of Medicine, University of Debrecen, Moricz Zs. krt 22, Debrecen, 4032, Hungary.

Background: The signs and symptoms of acute alcohol intoxication resemble those of vertebrobasilar stroke. Due to their shared symptoms including double vision, nystagmus, dysarthria, and ataxia, the differential diagnosis of alcohol intoxication and vertebrobasilar stroke may pose a challenge. Moreover, if alcohol intoxication and stroke occur simultaneously, the signs and symptoms of stroke may be attributed to the effects of alcohol, leading to delayed stroke diagnosis and failure to perform reperfusion therapy. Read More

World J Clin Cases 2019 Jan;7(1):73-78

Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.

Background: Millard-Gubler syndrome (MGS) is caused by a lesion in the brainstem at the level of the facial nerve nucleus, and it is also a rare ventral pontine syndrome. Vertebrobasilar artery dissection (VAD) is an uncommon cause of ischemic stroke. To the best of our knowledge, this is the first case report on the coexistence of MGS and VAD in a young acute ischemic stroke patient. Read More

World Neurosurg 2019 Jan 3. Epub 2019 Jan 3.

Department of Neurosurgery, Washington University, St. Louis, Missouri, USA; Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA; Department of Neurology, Washington University, St. Louis, Missouri, USA.

Background: The Pipeline Embolization Device (PED) has been increasingly used for the treatment of posterior circulation aneurysms. The purpose of the present study was to examine the clinical and angiographic outcomes of patients with vertebrobasilar aneurysms treated with the PED.

Methods: We performed a retrospective review of vertebrobasilar aneurysms treated with the PED at 4 high-volume neurovascular centers. Read More

Acta Neurochir Suppl 2019 ;125:151-158

Service de neurochirurgie, CHU, Strasbourg, France.

Compression syndromes of the vertebral artery that occur at the craniocervical junction are extremely rare causes of haemodynamic insufficiency of the posterior cerebral circulation. The aetiology of the compression syndrome may be a malformation, trauma, tumour, infection or degenerative pathology. This may lead to dynamic vertebral artery occlusion where the vessel courses around the atlas and the axis-the so-called V3 segment. Read More

Stroke 2019 Feb;50(2):495-497

From the Department of Neurosurgery (S.A.-H., C.J.S., X.D., L.R.-F., F.T.C.), University of Illinois at Chicago.

Background and Purpose- Cerebral hypoperfusion symptoms (defined as symptoms related to change in position, effort or exertion, or recent change in antihypertensive medication) have been used in stroke studies as a surrogate for detecting hemodynamic compromise. However, the validity of these symptoms in identifying flow compromise in patients has not been well established. We examined whether hypoperfusion symptoms correlated with quantitative measurements of flow compromise in the prospective, observational VERiTAS study (Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack and Stroke). Read More

Ann Clin Transl Neurol 2018 Dec 12;5(12):1562-1573. Epub 2018 Oct 12.

Department of Image People's Hospital of Zhengzhou Affiliated to Southern Medical University Zhengzhou China.

Objective: To investigate the association between the perfusion magnetic resonance imaging (MRI) and vertebrobasilar dolichoectasia (VBD) in vertigo patients and at least one vascular risk factor.

Methods: We studied 289 patients with vertigo (spinning, swaying, nausea, vomiting, and unsteady gait) who performed multimode MRI. Maximum diameter and tortuous parameters of the basilar artery and vertebral arteries were calculated using magnetic resonance angiography. Read More

Clin Neurol Neurosurg 2019 Jan 29;176:78-82. Epub 2018 Nov 29.

Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, China. Electronic address:

Objective: To compare the safety and efficacy of endovascular therapy in acute ischemic stroke (AIS) caused by large artery occlusion (LAO) in the posterior circulation with or without intracranial atherosclerosis (ICAS).

Patient And Methods: The study enrolled patients who underwent endovascular therapy for AIS caused by posterior circulation LAO. Inclusion criteria for endovascular therapy of vertebrobasilar occlusion were as follows: (1) CTA or MRA confirmed acute vertebrobasilar occlusion; (2) baseline NIHSS score ≥2; (3) premorbid mRS score ≤2; (4) onset or last known well time to puncture within 24 h; (5) pc-ASPECTS ≥6. Read More

Med Sci Monit 2018 Dec 12;24:9001-9006. Epub 2018 Dec 12.

Department of Radiology, Baoding First Central Hospital, Beijing, China (mainland).

BACKGROUND The present study was designed to evaluate the predictive value of head-neck computed tomography angiography (CTA) combined with ABCD2 score scale for patients with cerebral infarction of vertebrobasilar transient ischemic attack (TIA). MATERIAL AND METHODS A total of 92 patients with TIA who were admitted to our hospital from January 2014 to June 2015 were enrolled in this study. ABCD2 score and CTA combined with ABCD2 score were assessed. Read More

Angiol Sosud Khir 2018;24(4):104-108

Clinic of Faculty Surgery, Samara State Medical University of the RF Ministry of Public Health, Samara, Russia.

The authors examined efficacy of carotid endarterectomy (CEA) in treatment of patients suffering from vertebrobasilar insufficiency (VBI) without significant involvement of the vertebral arteries. The study included a total of 297 patients with VBI and diagnosed as having stenosis of the bifurcation of the carotid arteries amounting to 70% and more, with no significant involvement of the vertebral arteries revealed. All patients underwent CEA: eversion CEA was performed in 226 (76. Read More

Case Rep Neurol 2018 Sep-Dec;10(3):322-327. Epub 2018 Nov 14.

Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.

Cerebral ischemia may be rarely associated with a hypoplastic vertebrobasilar system. Intracranial lipoma is also a very rare congenital malformation. We report the case of a 52-year-old woman with vertebrobasilar transient ischemic attack associated with basilar artery hypoplasia and coincidental intracranial lipoma. Read More

eNeurologicalSci 2018 Dec 9;13:26-30. Epub 2018 Nov 9.

Department of Neurology, University Hospital of Heraklion, University of Crete, Greece.

Stroke is a frequent occurrence among patients suffering from systemic lupus erythematosus (SLE), but it rarely occurs as the initial manifestation of the disease. We here present the case of a 37 year-old patient who developed an acute cerebellar ischemic stroke as initial event of SLE: elevated partial thromboplastin time and ESR, thrombocytopenia, anti-ds-DNA, anti-SSA, anti-JO-1, and the lupus anticoagulant were detected, and the diagnosis of SLE was established. In addition, we reviewed the literature in order to clarify the demographic, clinical, imaging and outcome characteristics of such a presentation, and found 10 similar cases. Read More

World Neurosurg 2019 Feb 29;122:620-631. Epub 2018 Nov 29.

Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery, Fuxing Hospital, Capital Medical University, Beijing, China.

Objective: The repositioning of a dolichoectatic vertebrobasilar artery (VBA) for arterial decompression has been extensively used in the clinical setting. We aimed to describe and summarize the technical characteristics and clinical results of the sling technique.

Methods: The terms "dolichoectatic aneurysm," "dolichoectasia," "ectasia," and "megadolichoectasia" were used to search for pertinent reports related to the VBA territory. Read More

Interv Neuroradiol 2018 Dec 4:1591019918811800. Epub 2018 Dec 4.

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

Background: Therapeutic strategies and outcomes vary with stroke subtypes for patients with acute vertebrobasilar occlusion (VBAO). This study aimed to compare characteristics and outcomes of VBAO due to intracranial atherosclerotic disease (ICAD) and embolisms and identify baseline predictors of ICAD.

Methods: Patients with VBAO who received endovascular therapy (EVT) were retrospectively analyzed. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13166

Department of Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.

This study aims to analyze the clinical and imaging features of vertebrobasilar dolichoectasia (VBD) combined with posterior circulation infarction, and to explore risk factors for the occurrence of posterior circulation infarction in VBD patients.VBD patients were divided into 2 groups, according to the results of the imaging examination: posterior circulation infarction group and nonposterior circulation infarction group. The demographics, vascular risk factors, imaging, and other clinical data of the VBD patients were collected and retrospectively compared, and the risk factors for the occurrence of posterior circulation infarction in VBD patients were analyzed. Read More

Clin Neuroradiol 2018 Nov 29. Epub 2018 Nov 29.

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

Purpose: To investigate the predictors for good outcome of endovascular therapy (EVT) for patients with acute vertebrobasilar artery occlusion (VBAO) due to intracranial atherosclerosis stenosis (ICAS).

Methods: From April 2012 to February 2018, patients with VBAO due to ICAS who received EVT were retrospectively analyzed. ICAS was defined as fixed stenosis of >70%, or a degree of fixed stenosis >50% in addition to either perfusion impairment or evidence to re-occlusion. Read More

Front Neurol 2018 15;9:974. Epub 2018 Nov 15.

Department of Neurology, People's Hospital of Zhengzhou Affiliated to Southern Medical University, Zhengzhou, China.

The aim of this study was to determine the prevalence and associated factors of stroke and hypoperfusion among patients with isolated vertigo and vascular risk factors. We studied 157 patients with isolated vertigo who had undergone multimodal magnetic resonance imaging. Magnetic resonance angiography (MRA) was used to measure the diameters of vertebrobasilar arteries and to evaluate morphologic changes to vessels. Read More

J Clin Neurosci 2018 Nov 12. Epub 2018 Nov 12.

Mayo Clinic Department of Neurology, Mayo Clinic, Rochester, MN, USA. Electronic address:

Background: Vertebrobasilar dolichoectasia (VBDE) can present with brainstem- compressive symptoms, cerebral ischemia, or hemorrhage. Herein we describe a unique patient with VBDE who presented with hemorrhage and cerebral ischemia simultaneously.

Case: Patient is a 76-year-old man presenting with an acute, symptomatic left pontine ischemic stroke heralded by ataxic dysarthria and right ataxic-hemiparesis. Read More

Interv Neurol 2018 Oct 8;7(6):370-377. Epub 2018 Jun 8.

Emory University School of Medicine/Marcus Stroke & Neuroscience Center - Grady Memorial Hospital, Atlanta, Georgia, USA.

Introduction: Symptomatic intracranial hemorrhage represents one of the most feared complications of endovascular reperfusion. We aim to describe a series of patients that experienced immediate reperfusion injury with active intraprocedural extravasation within the territory of the deep penetrating arteries and provide real-time correlation with CT "spot sign."

Methods: This was a retrospective analysis of patients that suffered reperfusion injury with active arterial extravasation during endovascular stroke treatment in two tertiary care centers. Read More

Rinsho Shinkeigaku 2018 Oct 29;58(10):631-635. Epub 2018 Sep 29.

Department of Neurology, Kyoto Second Red Cross Hospital.

A 61-year-old man, with a history of right clavicular fracture 35 years prior, visited our hospital due to the sudden onset of vertigo and tinnitus following weakness and numbness in his left arm and leg. He also had a 6-month history of right arm pain with overuse. Brain MRI showed acute brain infarcts in the right posterior cerebral artery territory. Read More

J Stroke Cerebrovasc Dis 2018 Dec 23;27(12):3503-3504. Epub 2018 Sep 23.

Department of Neurosurgery, Kawasaki Municipal Hospital, Kawasaki city, Kanagawa, Japan.

Vertebrobasilar dolichoectasia sometimes presents with symptoms related to mass effect like cranial nerve palsies, or with ischemia or hemorrhage. Symptomatic hydrocephalus as a complication of vertebrobasilar dolichoectasia is extremely uncommon. Furthermore, there are few cases of vertebrobasilar dolichoectasia, in which cerebrospinal fluid flow disorder mechanisms are clearly demonstrated in neuroimaging findings. Read More

Front Neurol 2018 10;9:733. Epub 2018 Sep 10.

Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany.

Neurofibromatosis Type 2 (NF2) is an autosomal-dominant tumor-prone disorder characterized by the manifestations of central nervous system lesions. However, the first clinical signs of disease are often non-tumorous. Cerebrovascular insults are known in NF2, however, not yet described as first symptom in young NF2 patients. Read More

Zhonghua Yi Xue Za Zhi 2018 Sep;98(33):2636-2640

Department of Neurology, Henan Provincial People's Hospital, Zhengzhou 450003, China.

To explore the neuroimaging characteristics associated with the presence of patent foramen ovale(PFO) for patients with cryptogenic stroke. We retrospectively collected the clinical and imaging data of cryptogenic stroke patients with PFO and without PFO from Henan Province People's Hospital from January 1, 2013 to June 30, 2017. Lesion patterns and pertinent vascular territory were compared between the two groups. Read More

Acta Medica (Hradec Kralove) 2018;61(2):74-77

Department of Neurology, Comprehensive Stroke Center, Charles University, Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic.

Introduction: Causality of marijuana abuse with development of ischemic stroke has been indicated by numerous case reports and epidemiological studies. As a possible pathophysiological mechanism, the most common consideration is cardiac embolization during paroxysmal atrial fibrillation, systemic hypotension or multifocal intracerebral vasoconstriction.

Case Reports: We present three case reports of marijuana consumers who were admitted to our comprehensive stroke center due to ischemic stroke within 18-month period of our investigation. Read More

Cas Lek Cesk 2018 ;157(4):188-194

The benefit of mechanical thrombectomy over intravenous thrombolysis was definitively proved by several studies in 2015. It is relevant for proximal, large artery occlusions in the anterior circulation with onset of clinical symptoms lasting 6 hours. Two trials published in 2018 showed that in patients who are selected using CT perfusion or MR diffusion weighted imaging, thrombectomy significantly improves outcome even up to 24 hours from onset. Read More

Atherosclerosis 2018 Oct 17;277:42-46. Epub 2018 Aug 17.

Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan. Electronic address:

Background And Aims: Cervical spondylosis (CS) is reported to be associated with vertebrobasilar insufficiency. However, few cohort studies have investigated the association between CS and posterior circulation ischemic stroke.

Methods: The study cohort comprised 27,990 patients aged ≥18 years with a first diagnosis of CS. Read More

J Neurointerv Surg 2018 Aug 30. Epub 2018 Aug 30.

Department of Neurosurgery, Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Republic of Korea.

Background: Little has been reported about the feasibility and durability of a Low-profile Visualized Intraluminal Support Junior (LVIS Jr) Y-stenting device for wide-neck bifurcation aneurysms.

Purpose: To evaluate the feasibility and durability of LVIS Jr Y-stenting for coiling of unruptured wide-neck bifurcation aneurysms.

Methods: We identified patients in whom LVIS Jr Y-stenting was attempted for unruptured wide-neck bifurcation aneurysms from a prospectively maintained registry of a referral hospital. Read More

J Stroke Cerebrovasc Dis 2018 Nov 25;27(11):3294-3300. Epub 2018 Aug 25.

Marcyhealth Rockford, Rockford, Illinois.

Background: We performed this study to identify demographic, clinical, and angiographic characteristics of adult patients with angiographically confirmed vertebral artery occlusive disease (VAOD) and associated risk factors.

Methods: The demographic and clinical characteristics, and angiographic features were ascertained using predefined criteria. Controls were selected from the National Health and Nutrition Examination Surveys matched according to age, sex, and ethnicity. Read More

No Shinkei Geka 2018 Aug;46(8):663-671

Department of Neurosurgery, Kobe University Graduate School of Medicine.

Objective: Vertebral artery injury(VAI)associated with cervical spine trauma has the potential to cause catastrophic vertebrobasilar stroke. However, there are no well-defined treatment recommendations for VAI. The purpose of this study was to identify an effective treatment strategy for VAI following cervical spine trauma. Read More

J Stroke Cerebrovasc Dis 2018 Nov 6;27(11):3030-3035. Epub 2018 Aug 6.

Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province 210002. Electronic address:

Background: The incidence and predictors for in-stent restenosis (ISR) was not fully explored. We aim to investigate the incidence and predictors of ISR after stenting at the origin of vertebral artery.

Materials And Methods: Two hundred and six patients with 229 stents implantation between July 1, 2005 and July 31, 2015 were included in the study. Read More

Adv Gerontol 2018 ;31(2):266-272

Saint-Petersburg State University, 7-9, Universitetskaya emb., St. Petersburg, 199034, Russian Federation;

Current research aimed to reveal clinical and neurological features of ischaemic stroke (IS) in patients suffering from cerebral venous insufficiency (CVI) combined with arterial hypertension (AH) and to identify its risk factors. Examination data of 112 patients with IS (aged 60-93 years old; mean age 72,1±2,6 years old, males - 39 (34,8%), females - 73 (65,2%), admitted at regional vascular center of St. Elizabeth City Hospital in Saint Petersburg, highlighted that cephalgic syndrome and vestibulocerebellar dysfunction occurred more frequently in stroke patients with CVI. Read More

J Stroke Cerebrovasc Dis 2018 Oct 30;27(10):2822-2828. Epub 2018 Jul 30.

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

Background: The diffusion-weighted imaging (DWI) brain stem score (BSS) is an easy to use and can predict the clinical outcome of acute basilar artery occlusion (BAO) who underwent endovascular thrombectomy. The purpose of the current study was to validate its performance in Chinese acute BAO patients treated with mechanical thrombectomy.

Methods: Fifty consecutive patients with acute BAO who received early magnetic resonance imaging and treated with mechanical thrombectomy in a single-center were included. Read More

Stroke 2018 Aug;49(8):1893-1898

From the Department of Cerebrovascular Medicine (T.I., S.S., T.U., T.O., M.H., K.T., K.M.).

Background and Purpose- Patients with transient ischemic attack (TIA) occasionally show nonfocal symptoms, such as unconsciousness, amnesia, and unsteadiness. The purpose of this study was to clarify the characteristics and prognosis of patients with TIA with nonfocal symptoms, using data from the PROMISE-TIA (Prospective Multicenter Registry to Identify Subsequent Cardiovascular Events After Transient Ischemic Attack). Methods- Patients with TIA within 7 days of onset were consecutively enrolled in the Japanese nationwide registry. Read More

Stroke 2018 Aug;49(8):1953-1959

From the Departments of Neurosurgery (D.R.E., X.D., L.R.-F., F.T.C., S.A.-H.).

Background and Purpose- The VERiTAS (Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack and Stroke) study demonstrated posterior circulation distal flow status, determined by quantitative magnetic resonance angiography, is a robust predictor of vertebrobasilar stroke risk in patients with symptomatic atherosclerotic vertebrobasilar disease. Flow-compromised high-risk patients may benefit from flow-restoring endovascular procedures, such as submaximal angioplasty. In this study, we examine the cost-effectiveness of quantitative magnetic resonance angiography screening to identify patients who may benefit from submaximal angioplasty to restore vertebrobasilar flow. Read More

PLoS One 2018 10;13(7):e0200188. Epub 2018 Jul 10.

Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China.

Background: Evidence for the preventative effects of percutaneous transluminal angioplasty and stenting (PTAS) on the recurrence of stroke in patients with severe intracranial vertebrobasilar stenoses (IVBS) varies, and the influence of study characteristics on the study outcomes have not been determined.

Methods: A study level based meta-analysis was performed to investigate the influence of baseline characteristics on the 30-day and follow-up stroke recurrence or death in symptomatic IVBS patients receiving PTAS. Relevant single center studies were retrieved by searching PubMed and Embase. Read More

J Stroke Cerebrovasc Dis 2018 Sep 27;27(9):2367-2374. Epub 2018 Jun 27.

Ospedale Niguarda Cà Granda Milano.

Background: Acute basilar artery occlusion (BAO) is considered among the most severe medical emergencies, with very high morbidity and mortality. The aims of this study are to present 5 years experience of 12 centers in Lombardy region on BAO endovascular treatment and to evaluate prognostic factors that may improve clinical outcomes and recanalization rates.

Materials And Methods: Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) registry is a retrospective multicentric collection of patients with acute BAO who underwent endovascular treatment between 2010 and 2015. Read More

World Neurosurg 2018 Oct 23;118:e52-e58. Epub 2018 Jun 23.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address:

Background: Long-term outcome data for patients undergoing carotid endarterectomy (CEA) are lacking. As most of the published literature on CEA outcomes has been from high-volume providers, we wanted to investigate the outcomes of an average-volume cerebrovascular neurosurgeon.

Methods: We reviewed a single neurosurgeon's experience with CEA focusing on long-term outcomes. Read More

World Neurosurg 2018 Sep 22;117:285-291. Epub 2018 Jun 22.

Department of Neurosurgery, Erasmus MC University Medical Center, Erasmus MC Stroke Center, Rotterdam, The Netherlands; Department of Medical Decision Making, Erasmus MC, Rotterdam, The Netherlands. Electronic address:

Background: Persistent carotid-basilar connections have a prevalence of 0.14%. Recognizing such persistent fetal anastomoses between the carotid and the vertebrobasilar circulation is of great importance because they are reportedly associated with an increased prevalence of intracranial aneurysms. Read More

Neurol Med Chir (Tokyo) 2018 Jul 11;58(7):311-319. Epub 2018 Jun 11.

Department of Neurosurgery, St. Marianna University School of Medicine.

This study sought to analyze the incidence of contralateral microembolic infarctions (MIs) on diffusion-weighted imaging (DWI) following protected carotid artery stenting (CAS) and compared the difference of risk factors between ipsilateral and contralateral lesions. From April 2010 to March 2017, 147 CASs in 140 patients were performed. All the patients underwent DWI within 1 week before and 24 hrs after the procedures. Read More

J Stroke 2018 May 31;20(2):145-166. Epub 2018 May 31.

Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN, USA.

Atherosclerosis is a major cause of ischemic stroke that can be effectively prevented with appropriate lifestyle modifications and control of cardiovascular risk factors. Medical advances in recent years along with aggressive cardiovascular risk factor modifications have resulted in decreased recurrence rates of atherosclerotic stroke. Non-statin lipid-lowering molecules have recently shown clinical benefit and are recommended for very high-risk patients to reduce their risk of stroke. Read More

World Neurosurg 2018 Sep 7;117:32-39. Epub 2018 Jun 7.

Department of Neurosurgery, Baba Memorial Hospital, Sakai, Osaka, Japan.

Background: Basilar artery occlusion (BAO) is a rare, potentially fatal cause of ischemic stroke. It is often challenging to diagnose, especially when the presenting symptom is "seizures". We present 3 cases of patients with BAO presenting with seizures. Read More

Med Sci Monit 2018 Jun 8;24:3873-3881. Epub 2018 Jun 8.

Seventh Department of Neurology, Liaoning Province People's Hospital, Shenyang, Liaoning, China (mainland).

BACKGROUND MRI FLAIR hyperintense vessels sign (FHVs) is a special imaging marker that plays a key role in acute infarction imaging and diagnosis. However, FHVs have not been studied in the context of progressive posterior circulation infarction (PPCI), and little is known about the association of hyperintense endo-vessels sign (HEVs) on transverse section MRI with infarction. Thus, our objective here was to investigate the clinical significance of transverse MRI T2 HEVs in patients with PPCI. Read More

Surg Neurol Int 2018 16;9:82. Epub 2018 Apr 16.

Department of Neurosurgery, Suwa Red Cross Hospital, Kogandori, Suwa, Nagano, Japan.

Background: Revascularization of posterior circulation is essential in patients with severe bilateral vertebral artery (VA) stenosis despite administering maximal medical treatment, due to the high mortality of posterior circulation stroke.

Case Description: We present a 69-year-old man with bilateral severe VA stenosis at the origins, treated with occipital artery (OA)-distal VA anastomosis.

Conclusion: Endovascular treatment and other surgical treatments, such as bypass grafting, are effective, but OA-VA anastomosis is a safe and effective procedure for revascularization of the posterior circulation. Read More