2,212 results match your criteria Vertebrobasilar Stroke


Antiplatelet therapy within 24 hours of tPA: lessons learned from patients requiring combined thrombectomy and stenting for acute ischemic stroke.

J Cerebrovasc Endovasc Neurosurg 2020 Mar 31;22(1):1-7. Epub 2020 Mar 31.

Department of Neurosurgery, University of California, San Diego, La Jolla, CA, USA.

Objective: Although stroke guidelines recommend antiplatelets be started 24 hours after tissue plasminogen activator (tPA), select mechanical thrombectomy (MT) patients with luminal irregularities or underlying intracranial atherosclerotic disease may benefit from earlier antiplatelet administration.

Methods: We explore the safety of early (<24 hours) post-tPA antiplatelet use by retrospectively reviewing patients who underwent MT and stent placement for acute ischemic stroke from June 2015 to April 2018 at our institution.

Results: Six patients met inclusion criteria. Read More

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http://dx.doi.org/10.7461/jcen.2020.22.1.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307608PMC

Hypoperfusion Distal to Anterior Circulation Intracranial Atherosclerosis is Associated with Recurrent Stroke.

J Neuroimaging 2020 Jun 24. Epub 2020 Jun 24.

Department of Neurology, New York University, New York, NY.

Background And Purpose: In patients with symptomatic vertebrobasilar intracranial atherosclerotic disease (ICAD), impaired distal flow predicts recurrent stroke, but limited data exist on the association between perfusion status and recurrent stroke in anterior circulation ICAD.

Methods: This is a retrospective study of patients hospitalized for symptomatic ICAD with 50-99% stenosis of the intracranial carotid or middle cerebral artery. The primary outcome is recurrent symptomatic ischemic stroke in the territory of the artery with ≥50% stenosis within 90 days. Read More

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http://dx.doi.org/10.1111/jon.12710DOI Listing

Intracranial collaterals and arterial wall features in severe symptomatic vertebrobasilar stenosis.

Neurol Res 2020 Jun 23:1-8. Epub 2020 Jun 23.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases , Beijing, China.

Background And Aims: The protective role of intracranial primary collaterals on plaque vulnerability is not well established. We aimed to explore the association of intracranial collateral status with arterial wall features including arterial remodeling and culprit plaque features in severe symptomatic intracranial vertebrobasilar atherosclerosis (sIVBAS).

Methods: Posterior circulation stroke or TIA patients owing to sIVBAS from a three-dimensional high-resolution MRI (3D HRMRI) prospective observational study was included for current analysis. Read More

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http://dx.doi.org/10.1080/01616412.2020.1782081DOI Listing

Endovascular treatment of the vertebral artery origin stenosis by using the closed-cell, self-expandable Carotid Wallstent.

Interv Neuroradiol 2020 Jun 20:1591019920935276. Epub 2020 Jun 20.

Department of Neurology, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

Background: Endovascular treatment has been considered a good alternative to surgery for symptomatic vertebral artery origin stenosis (VAOS) due to the high risk of morbidity associated with surgery. The purpose of this study was to evaluate the feasibility and efficacy of insertion of the closed-cell, self-expandable Carotid Wallstent for the treatment of VAOS.

Methods: The records of 72 patients with VAOS refractory to adequate medication who were treated by endovascular treatment with the Carotid Wallstent from December 2006 to November 2018 were retrospectively evaluated. Read More

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http://dx.doi.org/10.1177/1591019920935276DOI Listing

Prothrombotic state induced by COVID-19 infection as trigger for stroke in young patients: A dangerous association.

eNeurologicalSci 2020 Sep 6;20:100247. Epub 2020 Jun 6.

Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

•COVID-19 infection could led to a pro-inflammatory and pro-thrombotic state.•Cerebrovascular involvement may occur in COVID-19 infection even in young patients.•Physicians should be aware that stroke may be the first COVID-19 manifestation. Read More

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http://dx.doi.org/10.1016/j.ensci.2020.100247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296339PMC
September 2020

Predicting Outcomes After Acute Reperfusion Therapy for Basilar Artery Occlusion.

Eur J Neurol 2020 Jun 17. Epub 2020 Jun 17.

Departments of Neurology and Radiology, Helsinki University Hospital, Helsinki, Finland.

Background: Basilar artery occlusion (BAO) leads to high rates of morbidity and mortality, despite successful recanalization. The discordance between flow restoration and long-term functional status clouds clinical decision making regarding further aggressive care. We sought to develop and validate a practical, prognostic tool for the prediction of 3-month favorable outcome after acute reperfusion therapy for BAO. Read More

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http://dx.doi.org/10.1111/ene.14406DOI Listing

Asymmetric SIRPIDs in a vertebrobasilar stroke: Implications for understanding its origin.

Clin Neurol Neurosurg 2020 Jun 2;196:105980. Epub 2020 Jun 2.

Departments of Intensive Medicine, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain; Biomedical Research Institute (IDIVAL), Santander, Spain.

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http://dx.doi.org/10.1016/j.clineuro.2020.105980DOI Listing

Bow hunter syndrome: A rare yet important etiology of posterior circulation stroke.

J Clin Neurosci 2020 Jun 7. Epub 2020 Jun 7.

Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.

A6-year-oldgirl presented with acute-onset headache andfluctuating right-sided weakness.HerPedNIHSSwas13. Brain MRI/MRA showed acute pontine arterial ischemic stroke(AIS)and remote right cerebellar and thalamic infarcts. Read More

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http://dx.doi.org/10.1016/j.jocn.2020.04.110DOI Listing

Optimized Hemodynamic Assessment to Predict Stroke Risk in Vertebrobasilar Disease: Analysis From the VERiTAS Study.

J Am Heart Assoc 2020 Jun 5;9(12):e016406. Epub 2020 Jun 5.

Department of Neurosurgery University of Illinois at Chicago IL.

Background Atherosclerotic vertebrobasilar disease is a significant etiology of posterior circulation stroke. The prospective observational VERiTAS (Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack and Stroke) study demonstrated that distal hemodynamic status is a robust predictor of subsequent vertebrobasilar stroke risk. We sought to compare predictive models using thresholds for posterior circulation vessel flows standardized to age and vascular anatomy to optimize risk prediction. Read More

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http://dx.doi.org/10.1161/JAHA.120.016406DOI Listing

[Occlusion of the vertebrobasilar artery. Case presentation and literature review].

Laeknabladid 2020 06;106(6):302-309

Dep. of Rehabilitation Landspitali University Hospital Iceland.

This paper is a case report of a 22 year old, previously healthy woman that presented comatose to the Emergency Room at Landspitali University Hospital Iceland. A CT image of the head on admission revealed a large right cerebellar infarct with oedema compressing the fourth ventricle. A CT angiogram on admission was suspicious for a dissection of the left vertebral artery (confirmed during endovascular treatment) and a total occlusion of the distal third of the basilar artery. Read More

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http://dx.doi.org/10.17992/lbl.2020.06.586DOI Listing

Practical value of three-dimensional high resolution magnetic resonance Vessel Wall imaging in identifying suspicious intracranial vertebrobasilar dissecting aneurysms.

BMC Neurol 2020 May 20;20(1):199. Epub 2020 May 20.

New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, No. 16 Xinjiekouwai Street, Xicheng District, Beijing, 100088, China.

Background: Direct evidence of intimal flaps, double lumen and intramural haematomas (IMH) is difficult to detect on conventional angiography in most intracranial vertebrobasilar dissecting aneurysms (VBDAs). Our purpose was to assess the value of three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR VWI) for identifying VBDAs.

Methods: Between August 2013 and January 2016, consecutive patients with suspicious VBDAs were prospectively enrolled to undergo catheter angiography and VWI (pre- and post-contrast). Read More

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http://dx.doi.org/10.1186/s12883-020-01779-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238595PMC

The influence of occluded artery and etiology of acute ischemic stroke on the long term outcomes after thrombectomy. A PRAGUE-16 substudy.

EuroIntervention 2020 May 19. Epub 2020 May 19.

Department of Cardiology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.

Aims: Thrombectomy is an effective treatment for acute ischemic stroke (AIS). The aim was to compare clinical outcomes with intracranial artery occlusion site among AIS patients treated in the setting of a cardiology cath-lab.

Methods And Results: Single center, prospective registry of 214 consecutive patients with AIS enrolled between 2012 and 2018. Read More

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http://dx.doi.org/10.4244/EIJ-D-19-00997DOI Listing

Clinically suspected concomitant spinal cord and vertebrobasilar infarctions caused by fibrocartilaginous embolism.

J Clin Neurosci 2020 Jul 11;77:222-224. Epub 2020 May 11.

Department of Neurology, Rouen University Hospital and University of Rouen, 76031 Rouen Cedex, France. Electronic address:

Fibrocartilaginous embolism (FCE) is a rare and probably under diagnosed cause of spinal cord infarction presumably due to acute embolization of nucleus pulposus fragments into the spinal circulation. Concomitant cerebral involvement is much rarer and often asymptomatic. Although the definitive diagnosis is histologic, certain criteria have been proposed to support the diagnosis in living patients, such as absence of vascular risk factors, acute onset or antecedent of valsalva maneuver before the episode and the exclusion of potential differential diagnoses. Read More

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http://dx.doi.org/10.1016/j.jocn.2020.05.021DOI Listing

Mechanical Thrombectomy for Tandem Vertebrobasilar Stroke: Characteristics and Treatment Outcome.

Stroke 2020 Jun 14;51(6):1883-1885. Epub 2020 May 14.

Department of Radiology, Yonsei University College of Medicine, Seoul, Korea (S.H.B., B.M.K., D.J.K.).

Background and Purpose- Tandem vertebrobasilar strokes are not well-known causes of posterior circulation stroke. The purpose of this study was to investigate the characteristics and outcome of mechanical thrombectomy in patients with tandem vertebrobasilar stroke. Methods- Acute basilar artery occlusion patients with tandem vertebral artery (VA) stenosis/occlusion who underwent mechanical thrombectomy were retrospectively analyzed. Read More

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http://dx.doi.org/10.1161/STROKEAHA.120.029503DOI Listing

Complicated vertebrobasilar dolichoectasia.

J Med Vasc 2020 May 8;45(3):165-167. Epub 2020 Apr 8.

Radiology department, Medicine and Pharmacy Faculty, University Sidi Mohammed ben Abdallah, CHU d'Hassan II, Fès, Morocco. Electronic address:

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http://dx.doi.org/10.1016/j.jdmv.2020.03.006DOI Listing

Fabry disease presenting as bilateral medial medullary infarction with a "heart appearance" sign: a case report.

BMC Neurol 2020 May 12;20(1):180. Epub 2020 May 12.

Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.

Background: The etiologic determinants of cryptogenic stroke remain a diagnostic challenge in clinical practice. Fabry disease (FD) is one of the monogenic causes of stroke that may remain unrecognized as a potential contributing causative factor, because of its rarity and difficulty in diagnosis. We report a case with rare bilateral medial medullary infarction manifesting as "heart appearance" who was diagnosed with FD. Read More

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http://dx.doi.org/10.1186/s12883-020-01766-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216630PMC
May 2020
2.040 Impact Factor

Safety and Durability of Concomitant Carotid Endarterectomy With Carotid Subclavian Bypass Grafting.

J Vasc Surg 2020 Apr 29. Epub 2020 Apr 29.

CAMC Health Education and Research Institute, 3211 MacCorkle Ave., SE, Charleston, WV 25304.

Background: Concomitant carotid endarterectomy (CEA) (for severe internal carotid artery (ICA) stenosis) and carotid subclavian bypass (CSBP) grafting (for proximal common carotid artery (CCA) or subclavian artery occlusions) is rarely utilized with only few studies were reported. This report will analyze early and late clinical outcome of the largest study to date of the combined procedures in our institution.

Methods: Electronic medical records of patients who had concomitant CEA with CSBP over 3 decades were analyzed. Read More

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http://dx.doi.org/10.1016/j.jvs.2020.03.058DOI Listing

Characteristics of Clinical Symptoms, Cerebral Images and Stroke Etiology in Vertebro-Basilar Artery Fenestration-Related Infarction.

Brain Sci 2020 Apr 20;10(4). Epub 2020 Apr 20.

Department of Neurology, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Cerebral artery fenestration is a rare variant of the vascular architecture, but its existence is well documented. The common site of fenestration is the vertebra-basilar artery and it may be found incidentally with subarachnoid hemorrhage. However, fenestration-related cerebral infarction is rare. Read More

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http://dx.doi.org/10.3390/brainsci10040243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226259PMC

Red flags for a concomitant giant cell arteritis in patients with vertebrobasilar stroke: a cross-sectional study and systematic review.

Acta Neurol Belg 2020 Apr 22. Epub 2020 Apr 22.

Department of Neurology, University Hospital Würzburg, Josef-Schneider Street 11, 97080, Würzburg, Germany.

Giant cell arteritis (GCA) may affect the brain-supplying arteries, resulting in ischemic stroke, whereby the vertebrobasilar territory is most often involved. Since etiology is unknown in 25% of stroke patients and GCA is hardly considered as a cause, we examined in a pilot study, whether screening for GCA after vertebrobasilar stroke might unmask an otherwise missed disease. Consecutive patients with vertebrobasilar stroke were prospectively screened for GCA using erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hemoglobin, and halo sign of the temporal and vertebral artery on ultrasound. Read More

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http://dx.doi.org/10.1007/s13760-020-01344-zDOI Listing

Kinking of Bilateral Internal Carotid Arteries as Cause of Cognitive Dysfunction.

Med Arch 2020 Feb;74(1):58-60

Department of Neurology, General Hospital «Prim.dr. Abdulah Nakas», Sarajevo, Bosnia and Herzegovina.

Introduction: Dolichoarteriopathies of the internal carotid artery (DICAs) is divided into three forms: tortuous, coiling and kinking. In case of kinking, internal carotid artery forms a sharp angle of <90 degrees, while in the background there is metaplasia of a tunica media with unknown etiology. The association with stroke is still questionable, but it is believed that it can be associated with cerebral ischemia and with clinical symptomatology that accompanies cerebral ischemia. Read More

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http://dx.doi.org/10.5455/medarh.2020.74.58-60DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164732PMC
February 2020

Cervical Spine Aneurysmal Bone Cyst in a Pediatric Patient: Embolization Considerations and Potential Pitfalls.

World Neurosurg 2020 Apr 16;139:163-168. Epub 2020 Apr 16.

Department of Neurosurgery, University of Nebraska Medical Center, Omaha.

Background: Aneurysmal bone cysts (ABCs) comprise 1%-2% of all bone tumors. ABCs involving the upper cervical spine in pediatric patients complicate intervention because of an immature skeleton and nearby neurovascular elements. Treatment often consists of surgical intervention with preoperative embolization to mitigate blood loss. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.04.005DOI Listing

Supracardiac atherosclerosis in embolic stroke of undetermined source: the underestimated source.

Eur Heart J 2020 Apr 16. Epub 2020 Apr 16.

Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, Rue du Bugnon 46, Lausanne CH-1011, Switzerland.

The term 'embolic stroke of undetermined source' (ESUS) is used to describe patients with a non-lacunar ischaemic stroke without any identified embolic source from the heart or the arteries supplying the ischaemic territory, or any other apparent cause. When the ESUS concept was introduced, covert atrial fibrillation was conceived to be the main underlying cause in the majority of ESUS patients. Another important embolic source in ESUS is the atherosclerotic plaque in the carotid, vertebrobasilar, and intracranial arteries, or the aortic arch-collectively described as supracardiac atherosclerosis. Read More

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http://dx.doi.org/10.1093/eurheartj/ehaa218DOI Listing

Coronary Calcium Score for the Prediction of Asymptomatic Coronary Artery Disease in Patients With Ischemic Stroke.

Front Neurol 2020 27;11:206. Epub 2020 Mar 27.

Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.

Many patients with ischemic stroke have concomitant coronary artery disease (CAD). However, it remains unclear which stroke patients should undergo evaluation for asymptomatic CAD, and which screening tools are appropriate. We investigated the role of coronary artery calcium (CAC) score as a screening tool for asymptomatic but severe CAD in acute stroke patients. Read More

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http://dx.doi.org/10.3389/fneur.2020.00206DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134382PMC

Diagnostic Value of Serum Biomarkers for Differentiating Central and Peripheral Causes of Acute Vertigo.

Front Med (Lausanne) 2020 19;7:84. Epub 2020 Mar 19.

Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, South Korea.

In patients presenting with acute vertigo or dizziness, distinguishing central from peripheral is a diagnostic challenge. This study investigated potential serum markers for differentiating central and peripheral vertigo in patients with acute-onset vertigo. This prospective case-control study recruited consecutive participants from the Emergency Department, including patients with acute-onset vertigo or dizziness within 12 h and control subjects. Read More

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http://dx.doi.org/10.3389/fmed.2020.00084DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096380PMC

The "distal-to-proximal" strategy for the treatment of posterior circulation tandem occlusions: a single-centre experience.

Neuroradiology 2020 Jul 3;62(7):867-876. Epub 2020 Apr 3.

Department of Neurosurgery, Changhai Hospital, Second Military Medical University, No.168 Changhai Rd, Shanghai, 200433, China.

Purpose: Data on posterior circulation tandem occlusions in acute ischemic stroke are scarce: recognition may be challenging and little is known about optimal treatment strategy. We report our endovascular treatment strategy for posterior circulation tandem occlusion.

Methods: Consecutive patients with posterior circulation tandem occlusions in our centre were enrolled retrospectively. Read More

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http://dx.doi.org/10.1007/s00234-020-02412-0DOI Listing
July 2020
2.485 Impact Factor

Recanalization of Tandem Vertebrobasilar Occlusions with Contralateral Vertebral Occlusion or Hypoplasia via either Direct Passage or the SHERPA Technique.

Interv Neurol 2020 Feb 27;8(1):13-19. Epub 2018 Sep 27.

Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Introduction: Tandem vertebral ostial disease with acute intracranial vertebrobasilar occlusion with contralateral vertebral occlusion or hypoplasia presents a unique challenge to the interventionalist.

Methods: The authors queried a prospectively maintained institutional endovascular database from August 2013 to June 2018 for cases of endovascularly treated acute tandem vertebrobasilar occlusions in the presence of contralateral vertebral occlusive disease or hypoplasia. Demographic and presentation data, the technique, results, and clinical outcome were extracted. Read More

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http://dx.doi.org/10.1159/000493198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098298PMC
February 2020

Vertebral Artery Stenoses Contribute to the Development of Diffuse Plaques in the Basilar Artery.

Front Bioeng Biotechnol 2020 6;8:168. Epub 2020 Mar 6.

PKU-HKUST Shenzhen-Hongkong Institution, Shenzhen, China.

Vertebral artery (VA) stenosis is relevant to a high early risk of recurrent stroke and basilar artery (BA) is the most common intracranial site of atherosclerotic lesions. It is important to show predictive risk factors for transient ischemic attack (TIA) or posterior infarctions. The aim of the study is to investigate morphometry and hemodynamics in intracranial vertebral and basilar arteries of health and diseased patients to enhance the risk assessment. Read More

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http://dx.doi.org/10.3389/fbioe.2020.00168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068210PMC

Intracranial Vertebrobasilar Calcification in Patients with Ischemic Stroke is a Predictor of Recurrent Stroke, Vascular Disease, and Death: A Case-Control Study.

Int J Environ Res Public Health 2020 03 18;17(6). Epub 2020 Mar 18.

Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria.

Intracranial artery calcification can be detected on nonenhanced brain computer tomography (NECT) and is a predictor of early vascular events. Here, we assessed the impact of vertebrobasilar artery calcification (VBC) on the long-term risk for recurrent stroke and vascular events. We performed a case-control trial of all consecutive stroke patients admitted to the University Hospital of Maribor, Slovenia over a period of 14 months. Read More

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http://dx.doi.org/10.3390/ijerph17062013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143103PMC

A unique temporary collateral pathway between carotid-vertebrobasilar arteries in a carotid dissection patient.

BMC Neurol 2020 Mar 17;20(1):97. Epub 2020 Mar 17.

Departments of Neurology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, 264000, People's Republic of China.

Background: In adults, the anastomosis between carotid and vertebrobasilar arteries is usually the posterior communicating artery, sometimes the primitive trigeminal artery. In this case, the basilar artery fed the internal carotid artery through the pontine-to-tentorial artery anastomosis after severe stenosis from traumatic carotid dissection.

Case Presentation: A 32-year-old female was diagnosed with ischemic stroke caused by traumatic carotid artery dissection. Read More

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http://dx.doi.org/10.1186/s12883-020-01651-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076917PMC

[Clinical characteristics of patients with stroke code activation not identified by the emergency medical service].

Rev Neurol 2020 Apr;70(7):251-256

Hospital Universitari Germans Trias i Pujol, 08916 Badalona, España.

Aims: To determine the sensitivity of stroke detection by emergency medical services (EMS) and to analyse the clinical characteristics of unidentified patients with suspected stroke.

Patients And Methods: Prospective register of patients with suspected stroke in our area (850,000 inhabitants) from 2011 to 2017. The population that notified the EMS was selected. Read More

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http://dx.doi.org/10.33588/rn.7007.2019161DOI Listing

Risk factors for calcification of the vertebrobasilar arteries in cardiovascular patients referred for a head CT, the SMART study.

J Neuroradiol 2020 Mar 10. Epub 2020 Mar 10.

Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. Electronic address:

Background And Purpose: Vertebrobasilar artery calcification (VBAC) has been associated with increased stroke occurrence. Little is known on VBAC risk factors, especially for patients with cardiovascular disease. We aimed to assess risk factors associated with VBAC in a cohort of cardiovascular patients referred for a head computed tomography (CT) scan. Read More

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http://dx.doi.org/10.1016/j.neurad.2020.02.004DOI Listing

Can Emergency Physicians Accurately Rule Out a Central Cause of Vertigo Using the HINTS Examination? A Systematic Review and Meta-analysis.

Acad Emerg Med 2020 Mar 13. Epub 2020 Mar 13.

and the, Division of Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.

Introduction: Dizziness is a common complaint presented in the emergency department (ED). A subset of these patients will present with acute vestibular syndrome (AVS). AVS is a clinical syndrome defined by the presence of vertigo, nystagmus, head motion intolerance, ataxia, and nausea/vomiting. Read More

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http://dx.doi.org/10.1111/acem.13960DOI Listing

Timing of procedural stroke and death in asymptomatic patients undergoing carotid endarterectomy: individual patient analysis from four RCTs.

Br J Surg 2020 May 12;107(6):662-668. Epub 2020 Mar 12.

Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.

Background: The effectiveness of carotid endarterectomy (CEA) for stroke prevention depends on low procedural risks. The aim of this study was to assess the frequency and timing of procedural complications after CEA, which may clarify underlying mechanisms and help inform safe discharge policies.

Methods: Individual-patient data were obtained from four large carotid intervention trials (VACS, ACAS, ACST-1 and GALA; 1983-2007). Read More

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http://dx.doi.org/10.1002/bjs.11441DOI Listing

Carotid, Vertebral, and Brachiocephalic Interventions.

Interv Cardiol Clin 2020 04;9(2):139-152

Section of Cardiovascular Medicine, Yale New Haven Hospital, New Haven, CT 06511, USA. Electronic address:

Carotid atherosclerosis most frequently manifests in the proximal internal carotid artery and the common carotid artery bifurcations. Subclavian artery atherosclerosis affects the proximal segments with a relatively higher incidence on the left and becomes clinically important in the presence of vertebrobasilar insufficiency or coronary steal. Atherosclerosis of the vertebral artery can lead to posterior circulation stroke. Read More

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http://dx.doi.org/10.1016/j.iccl.2019.12.008DOI Listing

An Unusual Cause of Vertebrobasilar Insufficiency in a Case of Atlantoaxial Dislocation with Anomalous Vertebral Artery.

World Neurosurg 2020 Jun 4;138:193-196. Epub 2020 Mar 4.

Department of Neurosurgery, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.

Background: Posterior circulation stroke resulting from atlantoaxial dislocation (AAD), although uncommon, is a well-described entity. The normally coursed V3 segment of the vertebral artery (VA) is likely to be stretched because of C1-C2 dislocation and further compromised by the C1-C2 translational mobility. The persistent first intersegmental artery (PFIA), an anomalous variant does not course through the C1 transverse foramen, but rather crosses the posterior C1-C2 joints and is unlikely to be affected by the C1-C2 dislocation. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.02.144DOI Listing

Vertebrobasilar Artery Calcification and Outcomes in Posterior Circulation Large Vessel Occlusion Thrombectomy.

Stroke 2020 Apr 14;51(4):1301-1304. Epub 2020 Feb 14.

From the Department of Medicine, University of Auckland, New Zealand (W.K.D., M.T.M.W., P.A.B.).

Background and Purpose- Intracranial carotid artery calcification is associated with worse outcome in anterior circulation stroke patients who undergo endovascular thrombectomy. We investigated the association between vertebrobasilar artery calcification (VBAC) and outcome in patients undergoing endovascular thrombectomy for posterior circulation large vessel occlusion. Methods- Consecutive patients treated for posterior circulation large vessel occlusion from a prospective single-center registry were studied. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.027958DOI Listing

Dynamic imaging of the craniovertebral junction is mandatory in patients with posterior circulation strokes.

Eur Spine J 2020 May 19;29(5):1078-1086. Epub 2020 Feb 19.

Department of Neurological Sciences, Christian Medical College, Vellore, India.

Introduction: The course of the vertebral artery after exiting from the C1 foramen transversarium and prior to entering the dura lends itself to compression in C1-2 instability. However, atlantoaxial dislocation presenting with vertebrobasilar insufficiency and posterior circulation stroke (PCS) is rare.

Methods: In this retrospective study, we identified 96 patients with PCS who had complete radiological data. Read More

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http://dx.doi.org/10.1007/s00586-020-06337-3DOI Listing
May 2020
2.473 Impact Factor

Corneal Involvement in Wallenberg Syndrome: Case Report and Literature Review.

Neuroophthalmology 2020 Feb 8;44(1):54-58. Epub 2019 Apr 8.

Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.

A 47-year-old man with Wallenberg syndrome after a stroke in the territory of the left vertebrobasilar artery and posterior inferior cerebellar artery, presented a week later complaining of visual loss in the left eye. Examination showed corneal anaesthesia associated with a neurotrophic corneal epithelial defect. Corneal involvement secondary to trigeminal neuropathy in Wallenberg syndrome is not frequently reported and may lead to epithelial erosion and neurotrophic keratopathy. Read More

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http://dx.doi.org/10.1080/01658107.2019.1602147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6999617PMC
February 2020

A New Method for Assessment of Upright Posture Intolerance.

Authors:
Adnan I Qureshi

J Vasc Interv Neurol 2020 Jan;11(1):42-45

Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA.

Background: Upright posture intolerance can be seen in a variety of diseases but the current methodology is not quantifiable and limits the ability to identify response to treatment.

Methods: A standard questionnaire was developed to assess the following aspects of upright posture tolerance: (1) How long can you stand straight without any support? (2) Do you feel any sense of sickness when you sit or lie down after standing? (3) How long do you have to wait before you are comfortable standing again after you have stood straight? (4) How effectively and fast can you get up from sitting or lying position to stand straight? and (5) rate the ability to perform activities on a standard vertical visual analog scale between 100 (can do everything) and 0 (cannot do anything). We tested the ability of the questionnaire in four patients to identify various aspects of upright posture intolerance. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6998804PMC
January 2020

Optical coherence tomography evaluation of vertebrobasilar artery stenosis: case series and literature review.

J Neurointerv Surg 2020 Feb 17. Epub 2020 Feb 17.

Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China

Background: Intracranial vertebrobasilar artery stenosis is an important cause of ischemic stroke. With its high resolution, intravascular optical coherence tomography (OCT) provides detailed assessment of vessel wall features. It is widely applied to identify high-risk plaque in the cardiovascular system, but its use in the intracranial artery has been limited. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-015660DOI Listing
February 2020

Thrombectomy in acute vertebrobasilar occlusion: a single-centre experience.

Neuroradiology 2020 Jun 13;62(6):723-731. Epub 2020 Feb 13.

Department of Neurosurgery, Inje University Haeundae Paik Hospital, 875, Haeun-daero, Haeundae-gu, Busan, Republic of Korea.

Purpose: Acute vertebrobasilar occlusion (VBO) has a grave clinical course; however, thrombectomy in VBO patients has rarely been reported. We retrospectively evaluated the clinical and radiological outcomes of thrombectomy in VBO patients.

Methods: From March 2010 to December 2017, 38 patients with 40 acute VBOs underwent thrombectomy at our hospital. Read More

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http://dx.doi.org/10.1007/s00234-020-02376-1DOI Listing

A 72-Year-Old Female With Bow Hunter Syndrome: A Rare Surgical Approach to C4-5 Vertebral Artery Decompression: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2020 Feb 10. Epub 2020 Feb 10.

Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.

Bow hunter syndrome is defined as vertebrobasilar insufficiency due to mechanical occlusion of the vertebral artery during head and neck rotation. In many cases, this is due to osteophyte formation, disc herniation, cervical spondylosis, tendinous bands, or tumors. Symptomatic disease may vary from inducing transient vertigo to posterior circulation stroke. Read More

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http://dx.doi.org/10.1093/ons/opaa011DOI Listing
February 2020

Endovascular treatment of patients with high-risk symptomatic intracranial vertebrobasilar stenoses: long - term outcomes.

Stroke Vasc Neurol 2019 Dec 2;4(4):182-188. Epub 2019 Jun 2.

Department of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Background And Purpose: We present the long-term outcome after endovascular treatment of symptomatic intracranial posterior circulation stenoses.

Methods: 30 patients with symptomatic intracranial posterior circulation stenoses exceeding 70% underwent endovascular treatment between 2006 and 2012. Data regarding presentation, follow-up, procedure details, complications and imaging follow-up were reviewed. Read More

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http://dx.doi.org/10.1136/svn-2019-000230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6979875PMC
December 2019

Relation of infarction location and volume to vertigo in vertebrobasilar stroke.

Brain Behav 2020 Mar 5;10(3):e01564. Epub 2020 Feb 5.

Department of Neurology, University Hospital of Alexandria, Alexandria, Egypt.

Objective: Vertigo is a common presentation of vertebrobasilar stroke. Anecdotal reports have shown that vertigo occurs more often in multiple than in single brainstem or cerebellar infarctions. We examined the relation between the location and volume of infarction and vertigo in patients with vertebrobasilar stroke. Read More

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http://dx.doi.org/10.1002/brb3.1564DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066346PMC

Anatomical Variations of Vertebrobasilar Artery are Closely Related to the Occurrence of Vertebral Artery Dissection-An MR Angiography Study.

J Stroke Cerebrovasc Dis 2020 Apr 31;29(4):104636. Epub 2020 Jan 31.

Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan.

Goal: Intracranial arterial dissection is a major cause of ischemic stroke and subarachnoid hemorrhage in relatively young patients. We assessed the hypothesis that the tortuosity of the vertebrobasilar artery is associated with the occurrence of vertebral artery (VA) dissection, using MR angiography (MRA).

Materials And Methods: This study enrolled 43 patients with VA dissection, and 63 age- and sex-matched healthy subjects were used as the controls. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104636DOI Listing

From Perviousness to Plaque Imaging in Acute Basilar Occlusions: The Impact of Underlying Stenosis and How to Detect It.

Stroke 2020 03 29;51(3):766-774. Epub 2020 Jan 29.

From the Department of Neuroradiology (M.T.B., D.P., C.M., B.F., C.Z., T.B.-B.), Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Germany.

Background and Purpose- Recent studies show that mechanical thrombectomy of acute basilar artery occlusions (BAO) results in high rates of successful recanalization and good outcomes, but predictors are not completely established yet. Varying occlusion types may benefit differently, and especially, an underlying basilar stenosis (BS) seems to have an impact. Aim of this study was to investigate angiographic and clinical differences in BAO subtypes and to test the potential of perviousness measures for a preinterventional identification of clinically relevant different occlusion types. Read More

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http://dx.doi.org/10.1161/STROKEAHA.119.027472DOI Listing

Predicting Endovascular Treatment Outcomes in Acute Vertebrobasilar Artery Occlusion: A Model to Aid Patient Selection from the ASIAN KR Registry.

Radiology 2020 Mar 28;294(3):628-637. Epub 2020 Jan 28.

From the Departments of Neurology (S.J.L., J.M.H., J.S.L.), Radiology (J.W.C.), and Biomedical Informatics (B.P.), Ajou University School of Medicine, and Office of Biostatistics, Ajou Research Institute for Innovative Medicine (J.H.P., B.P.), Ajou University Medical Center, 164 World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do 16499, Republic of Korea; Departments of Neurosurgery (D.H.K.), Radiology (D.H.K., Y.W.K., Y.S.K.), and Neurology (Y.W.K., Y.H.H.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea; and Departments of Neurology (J.H.H., J.Y., S.I.S.) and Neurosurgery (C.H.K.), Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.

Background The decision to perform endovascular treatment (EVT) for stroke related to vertebrobasilar occlusion (VBO) remains controversial. Purpose To identify preprocedural predictors of good outcomes and to develop a model to aid patient selection for VBO. Materials and Methods For this retrospective study using a Korean multicenter registry, a predictive model for good outcomes (modified Rankin scale score, 0-2) was generated based on a derivation sample of patients with VBO (January 2011-February 2016). Read More

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http://dx.doi.org/10.1148/radiol.2020191227DOI Listing

Left Vertebral Artery to Common Carotid Artery Transposition in a Patient With Bilateral Vertebral Insufficiency: 3-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2020 Jan 24. Epub 2020 Jan 24.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Extracranial vertebral artery (VA) atherosclerosis is responsible for 14% to 32% of posterior circulation infarctions.1 In the posterior circulation, narrowing of the VA > 30% is significantly associated with strokes. Subclavian artery (SCA) atherosclerosis can produce subclavian steal. Read More

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http://dx.doi.org/10.1093/ons/opaa001DOI Listing
January 2020

Limb shaking transient ischemic attacks: A follow-up of 28 patients.

Rev Neurol (Paris) 2020 Jan 6. Epub 2020 Jan 6.

Ege University, Medical School Hospital, Neurology Department, İzmir, Turkey.

Background: Limb shaking transient ischemic attack (LSTIA) is an uncommon picture of carotid-occlusive disease. The symptoms are a seizure like activity and misdiagnosed as partial motor seizures. We here present a series of patients in our registry who had limb-shaking activities and their long-term outcome after treatment of their disease. Read More

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http://dx.doi.org/10.1016/j.neurol.2019.12.001DOI Listing
January 2020