994 results match your criteria acute vertebrobasilar

Diagnostic and prognostic computed tomography imaging markers in basilar artery occlusion (Review).

Exp Ther Med 2021 Sep 6;22(3):954. Epub 2021 Jul 6.

Department of Neurology, 'George Emil Palade' University of Medicine, Pharmacy, Sciences and Technology, 540142 Târgu Mureș, Romania.

Acute ischemic stroke treatment has been revolutionized by the addition of mechanical and aspiration thrombectomy. Randomized controlled trials have proven beyond doubt, the substantial clinical impact of endovascular interventions in anterior circulation territory strokes. Unfortunately, patients with vertebrobasilar ischemic stroke could not be included in these early trials due to inherent clinical, radiological, and prognostic particularities of posterior circulation ischemia; thus, indications for the treatment of posterior fossa strokes and basilar artery occlusion (BAO) are mainly based on retrospective studies and registries. Read More

View Article and Full-Text PDF
September 2021

Diagnosis of Acute Central Dizziness With Simple Clinical Information Using Machine Learning.

Front Neurol 2021 12;12:691057. Epub 2021 Jul 12.

Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.

Acute dizziness is a common symptom among patients visiting emergency medical centers. Extensive neurological examinations aimed at delineating the cause of dizziness often require experience and specialized training. We tried to diagnose central dizziness by machine learning using only basic clinical information. Read More

View Article and Full-Text PDF

Flow Diversion for Reconstruction of Intradural Vertebral Artery Dissecting Aneurysms Causing Subarachnoid Hemorrhage-A Retrospective Study From Four Neurovascular Centers.

Front Neurol 2021 1;12:700164. Epub 2021 Jul 1.

Department of Neuroradiology, Radiology and Policlinic of Radiology, University Hospital Halle (Saale), Halle, Germany.

Dissecting aneurysms (DAs) of the vertebrobasilar territory manifesting with subarachnoid hemorrhage (SAH) are associated with significant morbi-mortality, especially in the case of re-hemorrhage. Sufficient reconstruction of the affected vessel is paramount, in particular, if a dominant vertebral artery (VA) is impacted. Reconstructive options include stent-assisted coiling and flow diversion (FD). Read More

View Article and Full-Text PDF

Staged Endovascular Treatment for Symptomatic Occlusion Originating From the Intracranial Vertebral Arteries in the Early Non-acute Stage.

Front Neurol 2021 16;12:673367. Epub 2021 Jun 16.

Department of Neurosurgery, Peking University First Hospital, Beijing, China.

The ideal treatment for patients who survive from acute vertebrobasilar artery occlusion but develop aggressive ischemic events despite maximal medical therapy in the early non-acute stage is unknown. This paper reports the technical feasibility and outcome of staged endovascular treatment in a series of such patients with symptomatic intracranial vertebral artery occlusion. Ten consecutive patients who presented with aggressive ischemic events in the early non-acute stage of intracranial vertebral artery occlusion from Jan 2015 to Nov 2020 were retrospectively reviewed. Read More

View Article and Full-Text PDF

Motor Vehicle Accident Due to Homonymous Hemianopia: An Unusual Presentation of Vertebrobasilar Stroke.

Cureus 2021 May 18;13(5):e15092. Epub 2021 May 18.

Medicine, Sultan Qaboos University Hospital, Muscat, OMN.

Acute ischemic stroke may present with various symptoms, including weakness, altered speech, and sensory and visual impairment. We present a case of a 57-year-old man who was brought to the emergency department after he sustained three minor motor vehicle accidents on the same day. After clinical assessment and detailed workup, we concluded that our patient had an acute ischemic infarct involving the left posterior cerebral artery territories causing right homonymous hemianopia resulting in motor vehicle accidents. Read More

View Article and Full-Text PDF

Mobile endovascular therapy for acute treatment of ruptured vertebral artery dissecting aneurysm in multiple hospitals.

Acta Neurochir (Wien) 2021 Jun 19. Epub 2021 Jun 19.

Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.

Background: The patients with ruptured vertebral artery dissecting aneurysm (rVADA) should be treated as early as possible because VADA carries extremely high risk of rebleeding in the acute phase. We have established a mobile endovascular strategy for the patients with rVADA between our flagship center and its affiliated local hospitals. We introduced and reviewed our mobile endovascular therapy in this study. Read More

View Article and Full-Text PDF

C-reactive Protein for Stroke Detection in the Emergency Department in Patients With Dizziness Without Neurological Deficits.

Front Neurol 2021 31;12:662510. Epub 2021 May 31.

Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Stroke diagnosis can be challenging in patients with dizziness without neurologic deficits. The aim of this study was to evaluate the predictive value of C-reactive protein (CRP) for identifying acute stroke in such patients. Data from adult patients (>18 years) admitted to the emergency department from August 2019 to February 2020 were evaluated. Read More

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

J Neurol Sci 2021 Aug 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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

[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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

Far-Lateral Transcondylar Approach to a Right Cervicomedullary Dural Arteriovenous Fistula of the Posterior Fossa.

J Neurol Surg B Skull Base 2021 Feb 5;82(Suppl 1):S43-S44. Epub 2020 Nov 5.

Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California, United States.

 Dural arteriovenous fistulas (DAVFs) at the cervicomedullary junction are uncommon and often accompanied by subarachnoid hemorrhage (SAH). We aim to illustrate in detail the microsurgical procedure for treating a DAVF located at the cervicomedullary junction.  We present a two-dimensional operative video that includes clinical history, preoperative imaging, surgical strategy, still images with labels, clinical course, and postoperative imaging. Read More

View Article and Full-Text PDF
February 2021

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

View Article and Full-Text PDF

Posterior Circulation Endovascular Thrombectomy for Large-Vessel Occlusion: Predictors of Favorable Clinical Outcome and Analysis of First-Pass Effect.

AJNR Am J Neuroradiol 2021 05 4;42(5):896-903. Epub 2021 Mar 4.

From the Unità Operativa Complessa Radiologia e Neuroradiologia (A.M.A., I.V., A.P.), Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia. Fondazione Policlinico Universitario A. Gemelli Istituto Di Ricovero e Cura a Carattere Scientifico, Roma, Italia.

Background And Purpose: Successful vessel recanalization in posterior circulation large-vessel occlusion is considered crucial, though the evidence of clinical usefulness, compared with the anterior circulation, is not still determined. The aim of this study was to evaluate predictors of favorable clinical outcome and to analyze the effect of first-pass thrombectomy.

Materials And Methods: A retrospective, multicenter, observational study was conducted in 10 high-volume stroke centers in Europe, including the period from January 2016 to July 2019. Read More

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

Comparisons of Characteristics and Outcomes after Mechanical Thrombectomy for Vertebrobasilar Occlusion with Cardioembolism or Atherosclerotic Brain Infarction: Data from the Tokyo-Tama-Registry of Acute Endovascular Thrombectomy (TREAT).

World Neurosurg 2021 04 26;148:e680-e688. Epub 2021 Jan 26.

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

Background: Some reports suggest the efficacy of mechanical thrombectomy (MT) for acute vertebrobasilar artery (VBA) occlusion. The major causes of VBA occlusion include cardioembolism (CE) and large-artery atherosclerosis (LAA). However, the clinical characteristics of each cause remain unclear, and they might be important for decision making related to the indications and strategy of MT. Read More

View Article and Full-Text PDF

Direct ultrasound-guided puncture of vertebral artery V2 segment during mechanical thrombectomy.

BMJ Case Rep 2021 Jan 26;14(1). Epub 2021 Jan 26.

Diagnostic and Interventional Imaging, University Hospital Policlinico Tor Vergata, Roma, Lazio, Italy.

An 83-year-old man experienced left upper limb uncontrolled movements preceded by intense gasping during night rest, which progressed to unconsciousness and respiratory arrest requiring intubation. He was diagnosed with acute stroke due to distal occlusion of the basilar artery and received indication for endovascular thrombectomy. Standard endovascular approach includes percutaneous puncture of the femoral or radial arteries; however, the presence of unfavourable vascular anatomies (stenotic origin and tortuosity) did not allow catheterisation of the intracranial vessels through conventional access, and based on the consistent time lapse from onset of symptoms and deterioration of the clinical condition, a direct right vertebral artery ultrasound-guided puncture was performed. Read More

View Article and Full-Text PDF
January 2021

Relationship Between Acute Neurological Function and Long-Term Prognosis in Patients with Large Arterial Occlusions.

J Stroke Cerebrovasc Dis 2021 Apr 23;30(4):105625. Epub 2021 Jan 23.

Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan. Electronic address:

Objectives: To clarify the relationship between early neurological symptoms and long-term functional outcomes of acute ischemic stroke, which would be beneficial for patient management and determining clinical study criteria of novel therapeutic interventions.

Materials And Methods: We retrieved data from the Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism Japan Registry 2 (RESCUE-Japan Registry 2) and investigated the association between 24- and 72-hour National Institutes of Health Stroke Scale (NIHSS) and 90-day modified Rankin Scale (mRS) scores, stratified by the site of occlusion (carotid or vertebrobasilar circulatory large arterial occlusion [ACO or PCO, respectively]) and endovascular recanalization therapy (EVT) performance. We examined the correlation using Spearman's rank correlation coefficient (rho). Read More

View Article and Full-Text PDF

Usefulness of vertebrobasilar artery radiological finding as a predictive and prognostic factor for sudden sensorineural hearing loss.

Auris Nasus Larynx 2021 Oct 13;48(5):823-829. Epub 2021 Jan 13.

Research Institute of Hearing Enhancement, Yonsei University Wonju College of Medicine, Wonju, South Korea. Electronic address:

Objective: The association between sudden sensorineural hearing loss (SSNHL) and radiological findings of the vertebrobasilar artery is not well-known and little research has been done. We hypothesized that the radiological features of the vertebrobasilar artery contribute to the incidence and prognosis of SSNHL.

Methods: We retrospectively enrolled patients diagnosed with unilateral SSNHL (SSNHL group) and those with acute vestibular neuritis (AVN; control group) in our hospital. Read More

View Article and Full-Text PDF
October 2021

Ruptured vertebrobasilar junction aneurysm unmasking subclavian steal syndrome.

Surg Neurol Int 2020 4;11:419. Epub 2020 Dec 4.

Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Background: Subclavian steal occurs due to stenosis or occlusion of the subclavian artery or innominate artery proximal to the origin of the vertebral artery. Often asymptomatic, the condition may be unmasked due to symptoms of vertebrobasilar insufficiency triggered by strenuous physical exercise involving the affected upper limb. The association of vertebrobasilar junction (VBJ) aneurysms with subclavian steal syndrome has been rarely reported. Read More

View Article and Full-Text PDF
December 2020

Thrombectomy for Posterior Circulation Stroke: Predictors of Outcomes in a Brazilian Registry.

World Neurosurg 2021 03 17;147:e363-e372. Epub 2020 Dec 17.

Division of Interventional Neuroradiology, Department of Radiology, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Background: Acute basilar artery occlusion is a devastating life-threatening condition. Early recanalization is the therapeutic goal in patients with acute ischemic stroke. Despite the high rates of recanalization achieved with modern devices for basilar occlusions, many patients have had poor clinical outcomes. Read More

View Article and Full-Text PDF

Predictors of favorable outcomes for vertebrobasilar artery occlusion after endovascular therapy within 24 hours of symptom onset.

Clin Neurol Neurosurg 2021 02 8;201:106422. Epub 2020 Dec 8.

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

Objective: The aim of the present study was to describe our results of endovascular therapy (EVT) for vertebrobasilar artery occlusion (VBAO) within 24 h of symptom onset, and to evaluate prognostic factors associated with favorable outcomes.

Methods: The present study enrolled patients who underwent EVT for acute ischemic stroke (AIS) caused by VBAO. Inclusion criteria for EVT to treat VBAO were as follows: (1) computed tomography angiography (CTA) or magnetic resonance angiography (MRA) confirmed acute VBAO; (2) baseline National Institutes of Health Stroke Scale (NIHSS) score ≥2; (3) premorbid modified Rankin scale (mRS) score ≤2; (4) onset or last known time to puncture within 24 h; and (5) posterior-circulation Acute Stroke Prognosis Early CT score (pc-ASPECTS) ≥6. Read More

View Article and Full-Text PDF
February 2021

The relationship between intracranial arterial dolichoectasia and intracranial atherosclerosis.

Clin Neurol Neurosurg 2021 01 4;200:106408. Epub 2020 Dec 4.

Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China. Electronic address:

Objective: We aimed to investigate the relationship between intracranial arterial dolichoectasia (IADE) and intracranial atherosclerosis (ICAS).

Methods: Patients with acute ischemic stroke were screened via the Nanjing Stroke Registry Program. Patients were diagnosed with IADE (diameter, height of bifurcation, and laterality of basilar artery) based on magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) results. Read More

View Article and Full-Text PDF
January 2021