vertebrobasilar insufficiency


Summary: Localized or diffuse reduction in blood flow through the vertebrobasilar arterial system, which supplies the BRAIN STEM; CEREBELLUM; OCCIPITAL LOBE; medial TEMPORAL LOBE; and THALAMUS. Characteristic clinical features include SYNCOPE; lightheadedness; visual disturbances; and VERTIGO. BRAIN STEM INFARCTIONS or other BRAIN INFARCTION may be associated.

Top Publications

  1. Flossmann E, Redgrave J, Briley D, Rothwell P. Reliability of clinical diagnosis of the symptomatic vascular territory in patients with recent transient ischemic attack or minor stroke. Stroke. 2008;39:2457-60 pubmed publisher
    ..However, there are few published data on the accuracy of clinical assessment of the vascular territory...
  2. Sweeney A, Doody C. The clinical reasoning of musculoskeletal physiotherapists in relation to the assessment of vertebrobasilar insufficiency: a qualitative study. Man Ther. 2010;15:394-9 pubmed publisher investigate the clinical reasoning processes of physiotherapists in relation to the assessment of vertebrobasilar insufficiency (VBI). Using a qualitative multiple case studies design 12 physiotherapists (mean=12...
  3. Mattle H, Arnold M, Lindsberg P, Schonewille W, Schroth G. Basilar artery occlusion. Lancet Neurol. 2011;10:1002-14 pubmed publisher
    ..The goal of thrombolysis is to restore blood flow in the occluded artery and salvage brain tissue; however, the best treatment approach to improve clinical outcome still needs to be ascertained...
  4. Vergouwen M, Algra A, Pfefferkorn T, Weimar C, Rueckert C, Thijs V, et al. Time is brain(stem) in basilar artery occlusion. Stroke. 2012;43:3003-6 pubmed publisher
    ..We investigated the relationship between time to recanalization therapy and functional outcome in BAO with data from the Basilar Artery International Cooperation Study (BASICS)...
  5. Divani A, Berezina T, Zhou J, Pakdaman R, Suri M, Qureshi A. Microscopic and macroscopic evaluation of emboli captured during angioplasty and stent procedures in extracranial vertebral and internal carotid arteries. J Endovasc Ther. 2008;15:263-9 pubmed publisher
    ..To compare the quantities of emboli dislodged during percutaneous transluminal angioplasty/stenting in the vertebral artery (VA) with those released during stent placement in the internal carotid artery (ICA)...
  6. Otto V, Fischer B, Schwarz M, Baumann W, Preibisch Effenberger R. Treatment of vertebrobasilar insufficiency--associated vertigo with a fixed combination of cinnarizine and dimenhydrinate. Int Tinnitus J. 2008;14:57-67 pubmed
    Thirty-seven patients suffering from vertigo associated with vertebrobasilar insufficiency participated in our prospective, single-center, double-blind, comparative study...
  7. Marquardt L, Kuker W, Chandratheva A, Geraghty O, Rothwell P. Incidence and prognosis of > or = 50% symptomatic vertebral or basilar artery stenosis: prospective population-based study. Brain. 2009;132:982-8 pubmed publisher
    ..Trials of interventional treatment are therefore likely to be feasible, but more data are required on the long-term risk of stroke on best medical treatment...
  8. Ohsaka M, Takgami M, Koyanagi I, Kim S, Houkin K. [Cerebral ischemia originating from rotational vertebral artery occlusion caused by C5/6 spondylotic changes: a case report]. No Shinkei Geka. 2009;37:797-802 pubmed
    ..In case of ischemic attack of the posterior circulation with lateral osteophyte formation of the cervical spine, dynamic occlusion mechanisms of the vertebral artery at the lower cervical level should be considered...
  9. Moubayed S, Saliba I. Vertebrobasilar insufficiency presenting as isolated positional vertigo or dizziness: a double-blind retrospective cohort study. Laryngoscope. 2009;119:2071-6 pubmed publisher
    ..The objective is to compare the presence of isolated positional vertigo or dizziness in patients with evaluation of VA morphology, thrombotic stroke risk factors, and evolution of symptoms with time...

More Information

Publications105 found, 100 shown here

  1. Ujifuku K, Hayashi K, Tsunoda K, Kitagawa N, Hayashi T, Suyama K, et al. Positional vertebral artery compression and vertebrobasilar insufficiency due to a herniated cervical disc. J Neurosurg Spine. 2009;11:326-9 pubmed publisher
    The authors report a case of vertebrobasilar insufficiency caused by vertebral artery (VA) compression due to a herniated cervical disc, which was surgically treated with the aid of intraoperative angiography...
  2. Sawlani V, Behari S, Salunke P, Jain V, Phadke R. "Stretched loop sign" of the vertebral artery: a predictor of vertebrobasilar insufficiency in atlantoaxial dislocation. Surg Neurol. 2006;66:298-304; discussion 304 pubmed
    ..Vertebrobasilar territory infarction is one of the rarer presentations of CVJ anomalies. A new radiologic sign due to stretching of the short third segment of VA detected on MRA/DSA may identify patients of AAD at risk of developing VBI...
  3. Foye P, Najar M, Camme A A, Stitik T, DePrince M, Nadler S, et al. Pain, dizziness, and central nervous system blood flow in cervical extension: vascular correlations to beauty parlor stroke syndrome and salon sink radiculopathy. Am J Phys Med Rehabil. 2002;81:395-9 pubmed
  4. Gulsun M, Saatci I, Akata D, Ozmen M, Sennaroglu L, Yucel T. [Radiologic investigation of vertebrobasilar insufficiency and quantification of vertebrobasilar flow with magnetic resonance imaging]. Tani Girisim Radyol. 2003;9:279-86 pubmed
    To evaluate the contribution of cervical spine radiograms, Doppler US, cervical and cranial MRI, MRA and two dimensional quantification flow in the diagnosis of vertebrobasilar insufficiency.
  5. Childs J, Flynn T, Fritz J, Piva S, Whitman J, Wainner R, et al. Screening for vertebrobasilar insufficiency in patients with neck pain: manual therapy decision-making in the presence of uncertainty. J Orthop Sports Phys Ther. 2005;35:300-6 pubmed
    ..with neck pain; however, considerable attention has also been afforded to the potential risks such as vertebrobasilar insufficiency (VBI)...
  6. Coward L, McCabe D, Ederle J, Featherstone R, Clifton A, Brown M. Long-term outcome after angioplasty and stenting for symptomatic vertebral artery stenosis compared with medical treatment in the Carotid And Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomized trial. Stroke. 2007;38:1526-30 pubmed
    ..We therefore compared these treatments in a randomized trial with long-term follow-up...
  7. Passero S, Rossi S. Natural history of vertebrobasilar dolichoectasia. Neurology. 2008;70:66-72 pubmed publisher
    ..The purpose of this study was to explore the natural history of VBD, evaluate its progression, and examine factors that may influence the clinical course of this condition...
  8. Yoo W, Lim Y, Ahn K, Choi B, Kim J, Kim S. Assessment of vertebral artery stents using 16-slice multi-detector row CT angiography in vivo evaluation: comparison of a medium-smooth kernel and a sharp kernel. Eur J Radiol. 2009;70:362-8 pubmed publisher
  9. Yamasoba T, Kikuchi S, Higo R. Deafness associated with vertebrobasilar insufficiency. J Neurol Sci. 2001;187:69-75 pubmed
    The incidence of auditory disturbances in vertebrobasilar insufficiency (VBI) is considered much rarer than vestibular disturbances, but no routine audiometric test results for VBI patients have been published...
  10. Welsh L, Welsh J, Lewin B, Dragonette J. Incompetent circle of Willis and vertebrobasilar insufficiency. Ann Otol Rhinol Laryngol. 2003;112:657-64 pubmed
    An analysis of the vascular basis of vertebrobasilar insufficiency was derived from the examination of 135 subjects by magnetic resonance imaging and angiography...
  11. Voetsch B, Dewitt L, Pessin M, Caplan L. Basilar artery occlusive disease in the New England Medical Center Posterior Circulation Registry. Arch Neurol. 2004;61:496-504 pubmed
    ..Most reports on basilar artery (BA) occlusive disease have retrospectively described single cases or small patient series...
  12. Arnold M, Nedeltchev K, Schroth G, Baumgartner R, Remonda L, Loher T, et al. Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysis. J Neurol Neurosurg Psychiatry. 2004;75:857-62 pubmed
    ..To define predictors of recanalisation and clinical outcome of patients with acute basilar artery occlusions treated with local intra-arterial thrombolysis (IAT)...
  13. Macleod M, Davis S, Mitchell P, Gerraty R, Fitt G, Hankey G, et al. Results of a multicentre, randomised controlled trial of intra-arterial urokinase in the treatment of acute posterior circulation ischaemic stroke. Cerebrovasc Dis. 2005;20:12-7 pubmed
    ..While intra-arterial thrombolysis may be used in this context, no randomised controlled data exist to support its safety or efficacy...
  14. Weber W, Mayer T, Henkes H, Kis B, Hamann G, Holtmannspoetter M, et al. Efficacy of stent angioplasty for symptomatic stenoses of the proximal vertebral artery. Eur J Radiol. 2005;56:240-7 pubmed
    ..To evaluate the safety and efficacy of stent angioplasty in the treatment of symptomatic arteriosclerotic stenoses of the proximal vertebral artery (VA)...
  15. Gupta R, Al Ali F, Thomas A, Horowitz M, Barrow T, Vora N, et al. Safety, feasibility, and short-term follow-up of drug-eluting stent placement in the intracranial and extracranial circulation. Stroke. 2006;37:2562-6 pubmed
    ..We report our technical success rate and short-term restenosis rates after stenting with DESs in the intracranial and extracranial circulation...
  16. Tsutsumi M, Kazekawa K, Onizuka M, Kodama T, Matsubara S, Aikawa H, et al. Stent fracture in revascularization for symptomatic ostial vertebral artery stenosis. Neuroradiology. 2007;49:253-7 pubmed
    ..We assessed the long-term follow-up examinations and complications of percutaneous transluminal angioplasty and stenting (PTAS) for symptomatic ostial vertebral artery (VA) stenosis...
  17. Nakagawa T, Shigeta T, Takashima T, Tomiyama K. Magnetic resonance angiography evaluation of basilar artery stenosis in patients with vertebrobasilar insufficiency. Eur Arch Otorhinolaryngol. 2000;257:409-11 pubmed
    ..basilar arterial flow by magnetic resonance angiography (MRA), MRA results for patients with vertebrobasilar insufficiency (VBI) were compared with those for age-matched individuals with no vestibular disorders...
  18. Cloud G, Markus H. Diagnosis and management of vertebral artery stenosis. QJM. 2003;96:27-54 pubmed
  19. Albuquerque F, Fiorella D, Han P, Spetzler R, McDougall C. A reappraisal of angioplasty and stenting for the treatment of vertebral origin stenosis. Neurosurgery. 2003;53:607-14; discussion 614-6 pubmed
    ..To assess the rate of restenosis after vertebral origin angioplasty and stenting (VOAS)...
  20. Wehman J, Hanel R, Guidot C, Guterman L, Hopkins L. Atherosclerotic occlusive extracranial vertebral artery disease: indications for intervention, endovascular techniques, short-term and long-term results. J Interv Cardiol. 2004;17:219-32 pubmed
    ..Careful selection of both symptomatic and asymptomatic patients for intervention based on neurological symptoms, as well as anatomical and hemodynamic considerations, is essential...
  21. Ko Y, Park S, Kim J, Min P, Choi E, Jung J, et al. Percutaneous interventional treatment of extracranial vertebral artery stenosis with coronary stents. Yonsei Med J. 2004;45:629-34 pubmed
    ..However, a relative high rate of in-stent restenosis remains as a problem to be resolved...
  22. Lin Y, Juang J, Jeng J, Yip P, Kao H. Symptomatic ostial vertebral artery stenosis treated with tubular coronary stents: clinical results and restenosis analysis. J Endovasc Ther. 2004;11:719-26 pubmed
    ..To evaluate the feasibility and safety of stent implantation to treat ostial vertebral artery stenosis...
  23. Muller R, Pfefferkorn T, Vatankhah B, Mayer T, Schenkel J, Dichgans M, et al. Admission facility is associated with outcome of basilar artery occlusion. Stroke. 2007;38:1380-3 pubmed
    ..We investigated whether initial admission to telemedically linked general hospitals with subsequent stroke-center transfer is related to poorer outcome than direct admission to stroke centers...
  24. Jiang W, Xu X, Du B, Dong K, Jin M, Wang Q, et al. Long-term outcome of elective stenting for symptomatic intracranial vertebrobasilar stenosis. Neurology. 2007;68:856-8 pubmed
    ..6%. At the last follow-up time, 73 patients were independent (modified Rankin scale grade < or = 2). The outcome compares favorably with medical therapy...
  25. Kim S, Baik M, Yoo S, Park I, Kim S, Kim M. Stent fracture and restenosis after placement of a drug-eluting device in the vertebral artery origin and treatment with the stent-in-stent technique. Report of two cases. J Neurosurg. 2007;106:907-11 pubmed
    ..The physical properties of metallic devices, stent strut geometry, and anatomical peculiarities of the subclavian artery may be associated with stent fractures. Earlier follow-up angiography studies (within 6 months) are warranted...
  26. Ubogu E, Zaidat O. Vertebrobasilar dolichoectasia diagnosed by magnetic resonance angiography and risk of stroke and death: a cohort study. J Neurol Neurosurg Psychiatry. 2004;75:22-6 pubmed
    ..This study was designed to elucidate the outcome and prognosis of adults diagnosed with VBD by magnetic resonance angiography (MRA) and to ascertain if these outcomes were independent of known vascular risk factors...
  27. Acar M, Degirmenci B, Yucel A, Albayrak R, Haktanir A, Yaman M. Comparison of vertebral artery velocity and flow volume measurements for diagnosis of vertebrobasilar insufficiency using color duplex sonography. Eur J Radiol. 2005;54:221-4 pubmed
    The aim of this study was to compare the measurements of vertebral artery (VA) systolic flow velocity and flow volume for diagnosis of vertebrobasilar insufficiency (VBI).
  28. Baird T, Muir K, Bone I. Basilar artery occlusion. Neurocrit Care. 2004;1:319-29 pubmed
    ..Increasing awareness of this condition may reveal the natural history to be more diverse than previously recognized...
  29. Morelli N, Gori S, Mancuso M, Murri L. Basilar artery fenestration in a woman with basilar-type migraine. Neurol Sci. 2007;28:116-7 pubmed
  30. Min J, Lee Y. Transcranial Doppler ultrasonographic evaluation of vertebral artery hypoplasia and aplasia. J Neurol Sci. 2007;260:183-7 pubmed
    ..TCD findings of HP or AP of VA are rarely known. Comparing with magnetic resonance angiography (MRA), we tried to evaluate characteristic findings of HP or AP of VA using TCD...
  31. Brighina F, Gurgone G, Gaglio R, Palermo A, Cosentino G, Fierro B. A case of atypical sporadic hemiplegic migraine associated with PFO and hypoplasia of vertebro-basilar system. J Headache Pain. 2009;10:303-6 pubmed publisher
    ..The atypical presentation of attacks with basilar symptoms and prolonged hemiplegia does not strictly fit the diagnostic criteria of ICHD-II. ..
  32. El Helou J, Saliba G, Kolev I, Pierrot Deseilligny C. Neuro-Whipple confirmed five years after a presumptive diagnosis of a primitive CNS vasculitis. J Neurol. 2008;255:925-6 pubmed publisher
  33. Wang D, Chen H, Liu J, Liu F, Wang L, Lu J. Treatment of patients older than 60 years with symptomatic vertebrobasilar artery stenosis. Chin Med J (Engl). 2008;121:1068-71 pubmed
    ..Furthermore, stent-assisted angioplasty is technically feasible and relatively safe in elderly patients. ..
  34. Lee W, Chen L, Waterston J. Vertebrobasilar ischaemia presenting as recurrent isolated vertigo. Acta Otolaryngol. 2011;131:887-9 pubmed publisher
    ..The findings of recurrent isolated vertigo and bilateral vestibular hypofunction should not prevent a search for vertebrobasilar ischaemia, particularly in the presence of vascular risk factors. ..
  35. Zhao Y, Jin M, Liu Q, Liu D, Chen J, Du B. [A long-term follow-up results of Enterprise stent in treatment of severe symptomatic basilar artery atherosclerotic stenosis]. Zhonghua Nei Ke Za Zhi. 2016;55:372-6 pubmed publisher
    ..Long term follow-up results show that Enterprise stent for the treatment of symptomatic basilar artery severe stenosis is safe and recurrence of stroke can be prevented effectively. ..
  36. Hong J, Choi J, Lee J, Yong S, Bang O, Joo I, et al. Impact of posterior communicating artery on basilar artery steno-occlusive disease. J Neurol Neurosurg Psychiatry. 2009;80:1390-3 pubmed publisher
    ..This result can be explained by the fact that patients with fetal-variant PcoA have a smaller area of posterior circulation and a possibility of retrograde filling into the upper brainstem through the fetal-variant PcoA. ..
  37. Compter A, van der Worp H, Algra A, Kappelle L. Prevalence and prognosis of asymptomatic vertebral artery origin stenosis in patients with clinically manifest arterial disease. Stroke. 2011;42:2795-800 pubmed publisher
    ..Patients with atherosclerotic arterial disease and asymptomatic VAo stenosis have a higher risk of posterior circulation ischemic stroke than patients without such a stenosis, but the absolute risk remains low. ..
  38. Wu L, Qin C, Ye Z, Mei Y, Zhou H, Hu B. [Diagnostic value of 64-slice spiral computed tomographic angiography in vertebral artery stenosis: a meta-analysis]. Zhonghua Yi Xue Za Zhi. 2011;91:1766-9 pubmed
    ..98 (0.91 - 1.00), 0.97 (0.94 -0.99), 838.40 and 0.9932 respectively. 64-slice spiral CTA has such a high level of accuracy, sensitivity and specificity in the non-invasive diagnosis of vertebral artery stenosis. ..
  39. Coleman D, Obi A, Criado E, Arya S, Berguer R. Contemporary outcomes after distal vertebral reconstruction. J Vasc Surg. 2013;58:152-7 pubmed publisher
    ..Distal VA reconstruction for flow-limiting or embolic lesions provides excellent stroke protection and symptomatic relief with acceptable perioperative risk in selected patients. ..
  40. Kawabori M, Kuroda S, Yasuda H, Hokari M, Nakayama N, Saito H, et al. Carotid endarterectomy for internal carotid artery stenosis associated with persistent primitive hypoglossal artery: efficacy of intraoperative multi-modality monitoring. Minim Invasive Neurosurg. 2009;52:263-6 pubmed publisher
    ..It is very important to monitor hemodynamic and/or electrophysiological status in both carotid and vertebrobasilar territories in order to perform carotid endarterectomy safely in such cases. ..
  41. Gallerini S, Calchetti B, Cianchi C, Di Troia A, Madonna R, Cresti A, et al. Can patent foramen ovale affect rehabilitation? The uncommon association of platypnea-orthodeoxia syndrome and stroke. Neurol Sci. 2011;32:513-4 pubmed publisher
    ..The stabilization of oxygen arterial saturation with postural changes and the disappearance of symptoms of POS allowed to develop the rehabilitation project with progressive neurological improvement. ..
  42. Huang Y, Hsiao M, Lee M, Huang Y, Lee J. Baclofen successfully abolished prolonged central hyperthermia in a patient with basilar artery occlusion. Acta Neurol Taiwan. 2009;18:118-22 pubmed
    ..Baclofen may be one of the treatment choices in patients with neurogenic central hyperthermia. ..
  43. Egashira Y, Satow T, Masuda K, Okawa M, Ohnishi H, Okazaki T, et al. [Carotid artery stenting for radiation-induced carotid stenosis]. No Shinkei Geka. 2010;38:913-20 pubmed
    ..Appropriate choice of a protection method could help in the reduction of unfavorable embolic complications and close postoperative follow up is mandatory. ..
  44. Yagi K, Nakagawa H, Mure H, Okita S, Nagahiro S. Cryptic Recanalization of Chronic Vertebral Artery Occlusion by Head Rotation. J Stroke Cerebrovasc Dis. 2017;26:e60-e61 pubmed publisher
    ..He also manifested vertigo with 30° leftward head rotation, indicative of rotational vertebrobasilar insufficiency due to mechanical compression of the patent left vertebral artery (VA) at the C4-C5 level...
  45. Holmes B, Green W, Kung N, Goebel J, Van Stavern G. Vertebrobasilar Dolichoectasia Causing An Optic Tract Syndrome. J Neuroophthalmol. 2017;37:179-181 pubmed publisher
  46. Sugrue P, Hage Z, Surdell D, Foroohar M, Liu J, Bendok B. Basilar artery occlusion following C1 lateral mass fracture managed by mechanical and pharmacological thrombolysis. Neurocrit Care. 2009;11:255-60 pubmed publisher
    ..In this case, chemical thrombolysis and mechanical thrombectomy resulted in recanalization of the basilar artery with excellent long-term neurological outcome. ..
  47. Slaba S, Braidy C, Sader R, Nassar J. [Intradural vertebral dissection: case report and literature review]. J Mal Vasc. 2009;34:218-21 pubmed publisher
    ..We report a case of atypical subarachnoid hemorrhage, with focus on contribution of the different techniques. ..
  48. Wu X, Xu Y, Hong B, Zhao W, Huang Q, Liu J. Endovascular reconstruction for treatment of vertebrobasilar dolichoectasia: long-term outcomes. AJNR Am J Neuroradiol. 2013;34:583-8 pubmed publisher
  49. Johnson S, Ducruet A, Bellotte J, Romero C, Friedlander R. Rotational Vertebral Artery Dissection Secondary to Anomalous Entrance into Transverse Foramen. World Neurosurg. 2017;108:998.e1-998.e5 pubmed publisher
    Rotational vertebral artery occlusion is a rare syndrome characterized by vertebrobasilar insufficiency secondary to position-dependent occlusion of the vertebral artery...
  50. Li S, Hong W, Li B, Wang J, Cao X, Liu X, et al. [Clinical study on endovascular treatment for symptomatic atherosclerotic stenosis of basilar artery]. Zhonghua Wai Ke Za Zhi. 2010;48:1466-9 pubmed
    ..PTAS is a feasible, safe and effective therapeutic method for the patients with symptomatic atherosclerotic stenosis of basilar artery. Further study in large number of patients is needed for long-term outcome. ..
  51. Yamaguchi R, Kohga H, Kurosaki M, Tamura M, Tanaka S, Tosaka M, et al. Acute basilar artery occlusion in a patient with left subclavian artery occlusion due to first rib anomaly: case report. Neurol Med Chir (Tokyo). 2008;48:355-8 pubmed
    ..Postoperative angiography demonstrated that the subclavian artery was recanalized with almost normal distal flow. The basilar artery was also recanalized. Thoracic outlet syndrome due to a first rib anomaly may cause stroke. ..
  52. Gulli G, Marquardt L, Rothwell P, Markus H. Stroke risk after posterior circulation stroke/transient ischemic attack and its relationship to site of vertebrobasilar stenosis: pooled data analysis from prospective studies. Stroke. 2013;44:598-604 pubmed publisher
    ..The high early risk of stroke provides a strong rationale for randomized trials to determine whether stenting can reduce risk. ..
  53. Kowoll C, Moeller Hartmann W, Fink G, Haupt W, Sobesky J. Acute interventional recanalisation of vertebrobasilar stenoses by angioplasty: complications and 12 months follow up. Neuroradiology. 2013;55:1135-41 pubmed publisher
    ..However, procedural safety and clinical outcome varied considerably. The results of aIR need to be assessed in multicentric registers to define the procedural risk and outcome in the clinical setting. ..
  54. Saposnik G, Noel de Tilly L, Caplan L. Pontine warning syndrome. Arch Neurol. 2008;65:1375-7 pubmed publisher
  55. Starke R, Chwajol M, Lefton D, Sen C, Berenstein A, Langer D. Occipital artery-to-posterior inferior cerebellar artery bypass for treatment of bilateral vertebral artery occlusion: the role of quantitative magnetic resonance angiography noninvasive optimal vessel analysis: technical case report. Neurosurgery. 2009;64:E779-81; discussion E781 pubmed publisher
    ..We present the case of a patient with symptoms of vertebrobasilar insufficiency without previous transient ischemic attacks or stroke...
  56. Ichikawa H, Mukai M, Ohno H, Shimizu Y, Itaya K, Kawamura M. Deep white matter hyperintensities, decreased serum low-density lipoprotein, and dilative large arteriopathy. J Stroke Cerebrovasc Dis. 2012;21:225-30 pubmed publisher
    ..An analysis including the BA area yielded similar results. DWMHs are manifestations of SVDs and show a strong association with lower serum LDL level, lower eGFR, and BA dilatation. ..
  57. Alcalá Cerra G, Gutiérrez Paternina J, Niño Hernández L, Moscote Salazar L, Polo Torres C, Sabogal Barrios R. [Brain stem compression preceded by trigeminal neuralgia in a patient with vertebro-basilar and bilateral carotid dolichoectasia]. Bol Asoc Med P R. 2011;103:34-7 pubmed
  58. Haimoto S, Nishimura Y, Hara M, Yamamoto Y, Fukuoka T, Fukuyama R, et al. Surgical Treatment of Rotational Vertebral Artery Syndrome Induced by Spinal Tumor: A Case Report and Literature Review. NMC Case Rep J. 2017;4:101-105 pubmed publisher
    b>Vertebrobasilar insufficiency (VBI) provoked by physiological head rotation is known as rotational vertebral artery syndrome (RVAS) or Bow Hunter syndrome...
  59. Yoshimura S, Toyoda K, Ohara T, Nagasawa H, Ohtani N, Kuwashiro T, et al. Takotsubo cardiomyopathy in acute ischemic stroke. Ann Neurol. 2008;64:547-54 pubmed publisher
    ..It most often occurred soon after stroke onset and was commonly asymptomatic. Female sex and insular damage were predominant features of the stroke patients who experienced development of takotsubo cardiomyopathy. ..
  60. Furtado S, Venkatesh P, Murthy G, Furtado A, Hegde A. Paradoxical embolus across atrial septal defect and posterior circulation infarct in neurosurgical patients. Int J Neurosci. 2010;120:516-20 pubmed publisher
    ..Closure of cardiac shunts is warranted before non-emergent neurosurgical operations. During emergency craniotomies, proper precautions should be taken to reduce the incidence of venous air embolism and paradoxical embolism. ..
  61. Sairanen T, Strbian D, Soinne L, Silvennoinen H, Salonen O, Artto V, et al. Intravenous thrombolysis of basilar artery occlusion: predictors of recanalization and outcome. Stroke. 2011;42:2175-9 pubmed publisher
    ..Basilar artery occlusion has a high mortality rate (85% to 95%) if untreated. We describe a large single-center cohort treated mostly with intravenous alteplase and heparin...
  62. Al Ali F, Barrow T, Duan L, Jefferson A, Louis S, Luke K, et al. Vertebral artery ostium atherosclerotic plaque as a potential source of posterior circulation ischemic stroke: result from borgess medical center vertebral artery ostium stenting registry. Stroke. 2011;42:2544-9 pubmed publisher
    ..Finally, patients had a very low rate of symptom recurrence after treatment. These 3 observations point strongly to VAO plaque as a potential source of some posterior circulation stroke. ..
  63. Darkhabani M, Thompson M, Lazzaro M, Taqi M, Zaidat O. Vertebral artery stenting for the treatment of bow hunter's syndrome: report of 4 cases. J Stroke Cerebrovasc Dis. 2012;21:908.e1-5 pubmed publisher
    Bow hunter's syndrome (BHS) is a rare condition resulting from vertebrobasilar insufficiency secondary to mechanical occlusion or stenosis of the vertebral artery (VA) due to head rotation...
  64. Kuliha M, Roubec M, Jonszta T, Krajca J, Czerny D, Krajina A, et al. Safety and efficacy of endovascular sonolysis using the EkoSonic endovascular system in patients with acute stroke. AJNR Am J Neuroradiol. 2013;34:1401-6 pubmed publisher
    ..7% patients, P = .013). In this small study, EkoSonic endovascular sonolysis allowed safe and potentially effective revascularization in patients experiencing acute ischemic stroke. ..
  65. Zhang D, Zhang S, Zhang H, Xu Y, Fu S, Yu M, et al. Evaluation of vertebrobasilar artery changes in patients with benign paroxysmal positional vertigo. Neuroreport. 2013;24:741-5 pubmed publisher
    ..05). Vertigo severity correlated with VA stenosis or occlusion, VA dominance, and unilateral or bilateral VA tortuosity. VBA tortuosity and VA dominance were common in BPPV patients and may contribute toward BPPV. ..
  66. Kumar N, Padala R, Tirupati S, Tatikonda A. Rhinocerebral Mucormycosis with Top of Basilar Artery Syndrome. J Stroke Cerebrovasc Dis. 2016;25:378-82 pubmed publisher
    ..Mucormycosis has a very fatal rapid progression with varied forms of cerebral dissemination with high mortality; hence early recognition and aggressive treatment are needed to increase the survival rate. ..
  67. Ulu M, Beker Acay M, Ulu S, Unlu E, Bucak A, Yaman G, et al. Vertebrobasilar insufficiency and gamma-glutamyltransferase: An emerging relationship demonstrating inflammation and atherosclerosis. Bratisl Lek Listy. 2016;117:448-52 pubmed
    b>Vertebrobasilar insufficiency (VBI) is a pathology arising from the reduction in flow rate of vertebral arteries and mainly caused by inflammation and atherosclerosis...
  68. Alabri H, Lewis W, Manjila S, Alkhachroum A, De Georgia M. Acute Bilateral Ophthalmoplegia Due to Vertebrobasilar Dolichoectasia: A Report of Two Cases. Am J Case Rep. 2017;18:1302-1308 pubmed
    ..Clinical management of VBD is a challenge as there are no current management guidelines. Therefore, clinical management of cases of VBD should be individualized to balance the risks and benefits of treatment options for each patient...
  69. Yanagawa Y, Iwamoto S, Nishi K. Pontine infarction induced by injury of the perforating branch of the basilar artery after blunt head impact: case report. Neurol Med Chir (Tokyo). 2008;48:343-6 pubmed
    ..The present elderly patient had hypertension and hyperlipidemia, so arteriosclerosis in the paramedian branch may have contributed to his susceptibility to such injury. ..
  70. Deftereos S, Panagopoulos G, Eleftheriadou A, Korres S, Georgonikou D, Kandiloros D, et al. Using vestibular evoked myogenic potentials to localise brainstem lesions. A preliminary report. B-ENT. 2008;4:215-9 pubmed
    ..BAERs waves IV and V were absent on the right. VEMPs were normal. VEMPs are affected by lesions of the lateral lower pons and upper medulla. Our results suggest that they may be a useful addition in the localisation of such lesions. ..
  71. Katsuno M, Mizunari T, Kobayashi S, Takahashi H, Teramoto A. Rupture of a vertebral artery dissecting aneurysm developing immediately after trapping of a dissecting aneurysm on the contralateral vertebral artery: case report. Neurol Med Chir (Tokyo). 2009;49:468-70 pubmed
  72. Benglis D, Levi A. Neurologic findings of craniovertebral junction disease. Neurosurgery. 2010;66:13-21 pubmed publisher
    ..We categorized the various pathologies of the craniovertebral junction and their unique neurologic presentations. New developments in the fields of neuroscience of spinal tract lesioning are also discussed...
  73. Jenkins J, Patel S, White C, Collins T, Reilly J, McMullan P, et al. Endovascular stenting for vertebral artery stenosis. J Am Coll Cardiol. 2010;55:538-42 pubmed publisher
    ..We conclude that endovascular stenting of vertebral artery atherosclerotic disease is safe and effective compared with surgical controls and should be considered first-line therapy for this disease. ..
  74. Macleod D, McAuley D. Vertigo: clinical assessment and diagnosis. Br J Hosp Med (Lond). 2008;69:330-4 pubmed
    ..This review focuses on bedside assessment of vertigo and, by looking at patterns of symptoms and signs, provides guidance as to when to suspect a central cause...
  75. Zhang R, Zhou G, Xu G, Liu X. Posterior circulation hyperperfusion syndrome after bilateral vertebral artery intracranial stenting. Ann Vasc Surg. 2009;23:686.e1-5 pubmed publisher
    ..A 51-year-old woman who had repeated episodes of dizziness, nausea, and vomiting was diagnosed with vertebrobasilar insufficiency. Diffusion-weighted magnetic resonance imaging showed a lesion in the posterior inferior cerebellar ..
  76. Lu D, Gupta N, Mummaneni P. Minimally invasive decompression of a suboccipital osseous prominence causing rotational vertebral artery occlusion. Case report. J Neurosurg Pediatr. 2009;4:191-5 pubmed publisher
    ..Successful decompression of the VA was performed via a minimally invasive 22-mm tubular retractor. This is the first reported case report of a minimally invasive decompression of the VA between the skull base and C-1...
  77. Chakravarty A. Hemifacial spasm, glossodynia, and dolichoectasia of the basilar artery. J Stroke Cerebrovasc Dis. 2012;21:78-81 pubmed publisher
    ..It is suggested that the neurologic symptoms most likely resulted from pontine compression, rather than from any compression of the cranial nerves...
  78. Kim B, Kim S, Kim D, Shin Y, Suh S, Kim D, et al. Outcomes and prognostic factors of intracranial unruptured vertebrobasilar artery dissection. Neurology. 2011;76:1735-41 pubmed publisher
    ..We aimed to evaluate the long-term clinical outcomes and prognostic factors of symptomatic intracranial unruptured vertebrobasilar artery dissection (siu-VBD)...
  79. Mitrasinovic A, Radak S, Kolar J, Aleksic N, Otasevic P, Popovic M, et al. Color Doppler sonographic evaluation of flow volume of the internal carotid and vertebral arteries after carotid endarterectomy. J Clin Ultrasound. 2010;38:238-43 pubmed publisher
    ..We correlated the result with the degree of stenosis of the ICA...
  80. Vicenzini E, Ricciardi M, Sirimarco G, Di Piero V, Lenzi G. Extracranial and intracranial sonographic findings in vertebral artery diseases. J Ultrasound Med. 2010;29:1811-23 pubmed
    ..The aim of this review is to illustrate the sonographic features that can be detected in vertebral artery (VA) diseases...
  81. Lee C, Morasch M. Treatment of vertebral disease: appropriate use of open and endovascular techniques. Semin Vasc Surg. 2011;24:24-30 pubmed publisher
    ..Surgical and endovascular techniques are discussed and reviewed in the context of the location and type of vertebral artery disease...
  82. Giglia G, Romano M, Paladino P, Virzi V, Narese F, Palermo A, et al. A painful tic convulsif due to double neurovascular impingement. J Headache Pain. 2011;12:653-6 pubmed publisher
    ..i.d. that was able to reduce attacks from 4 to 6 times per day to 1 to 2 per week. Considering the good response to the drug, the neurosurgeon decided to delay surgical treatment...
  83. Noorian A, Gupta R, Nogueira R. Stenting of complete vertebral artery ostial occlusion in a patient with medically refractory vertebrobasilar ischemia. J Neurointerv Surg. 2012;4:e31 pubmed publisher
    ..The complete occlusion was successfully treated with a drug-eluting stent. The patient has been symptom-free for 6 months. Stenting of vertebral artery ostial occlusion is technically feasible in well-selected cases...
  84. Patel I, Bezerra H, Costa M, Fujino Y, Hsu D. Novel use of optical coherence tomography. J Neurointerv Surg. 2013;5:e41 pubmed publisher
    ..To date, no detailed descriptions or case reports have previously been reported regarding the use of neuroendovascular OCT in diseased arteries. ..
  85. Fiehler J, Thomalla G. [Vertebrobasilar occlusions : Pathophysiology, diagnostics and treatment]. Radiologe. 2009;49:319-27 pubmed publisher
    ..This review paper focuses on the clinical and pathophysiological details that are crucial for decision-making...
  86. Lachaud S, Suissa L, Mahagne M. [Stroke, HIV and meningovascular syphilis: study of three cases]. Rev Neurol (Paris). 2010;166:76-82 pubmed publisher
    ..Various clinical manifestations can occur in syphilis, especially meningovascular syphilis. We report three cases of ischemic stroke related to meningovascular syphilis and HIV infection...
  87. Parkhutik V, Lago A, Tembl J, Aparici F, Vazquez V, Mainar E. Angioplasty and stenting of symptomatic and asymptomatic vertebral artery stenosis: to treat or not to treat. Eur J Neurol. 2010;17:267-72 pubmed publisher
    ..Even less is known about endovascular treatment of asymptomatic cases. We treated symptomatic and asymptomatic vertebral ostium stenosis with angioplasty and stenting and investigated the long term outcome...
  88. Chung S, Lee D, Choi J, Choi B, In H, Kim S, et al. Use of self-expanding stents for the treatment of vertebral artery ostial stenosis: a single center experience. Korean J Radiol. 2010;11:156-63 pubmed publisher
    ..To evaluate our early experience using self-expanding stents to treat atherosclerotic vertebral artery ostial stenosis (VAOS), with respect to technical feasibility and clinical and imaging follow-up results...
  89. Freitas H, Chizzola P, Pinha F, Velloso L. [Infective endocarditis with initial presentation of acute abdomen]. Arq Bras Cardiol. 2010;94:e106-8 pubmed
    ..Transesphofagic echocardiogram showed vegetation of the aortic valve and moderate aortic insufficiency. Blood cultures were positive for Enterococcus bovis...
  90. Ishiyama G, Ishiyama A. Vertebrobasilar infarcts and ischemia. Otolaryngol Clin North Am. 2011;44:415-35, ix-x pubmed publisher
    ..A high incidence of recurrence of ischemic attacks or infarcts in vertebrobasilar insufficiency is noted...
  91. Kim C, Sohn J, Choi H. Vertebrobasilar angulation and its association with sudden sensorineural hearing loss. Med Hypotheses. 2012;79:202-3 pubmed publisher
    ..Vertebrobasilar junction angulation could represent a simple and useful marker of SSNHL caused by a vascular compromise of the cochlea...
  92. Kakino S, Ogasawara K, Kubo Y, Kashimura H, Konno H, Sugawara A, et al. Clinical and angiographic long-term outcomes of vertebral artery-subclavian artery transposition to treat symptomatic stenosis of vertebral artery origin. J Neurosurg. 2009;110:943-7 pubmed publisher
    ..Therefore, the authors assessed the long-term clinical and angiographic outcomes in patients after VA-subclavian artery (SA) transposition...