scholarly journals Does Small Size Vertebral or Vertebrobasilar Artery Matter in Ischemic Stroke?

10.5772/27006 ◽  
2012 ◽  
Author(s):  
Jong-Ho Park
Keyword(s):  
Ischemic Stroke ◽  
Vertebrobasilar Artery

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

2020 ◽  
Vol 17 (6) ◽  
pp. 2013
Author(s):  
Jožef Magdič ◽  
Nino Cmor ◽  
Matevž Kaube ◽  
Tanja Hojs Fabjan ◽  
Larissa Hauer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Vascular Disease ◽  
Recurrent Stroke ◽  
Case Control ◽  
University Hospital ◽  
Stroke Recurrence ◽  
Vascular Events ◽  
Vertebrobasilar Artery ◽  
The Impact

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. VBC was defined as presence of a hyperdense area within vertebrobasilar arteries that exceeds > 90 Hounsfield units as seen on NECT. Clinical follow-up information was obtained from the hospital documentation system and mortality registry of the district and included recurrent stroke, subsequent vascular events (myocardial infarction, heart failure, peripheral arterial occlusive disease), and death. We followed a total of 448 patients for a median of 1505 days (interquartile range, IQR 188-2479). Evidence for VBC was present in 243 (54.2%) patients. Median age was 76 years, recurrent stroke occurred in 33 (7.4%), any vascular events in 71 (15.8%), and death in 276 (61.6%). VBC was associated with a higher risk of recurrent stroke (hazard ratio, HR 3.13, 95% confidence interval (CI 1.35–7.20)) and vascular events (HR 2.05, 95% CI 1.21–3.47). Advanced age, male gender, and ischemic stroke involving the entire anterior circulation raised the likelihood for death. We conclude that the presence of VBC in patients with ischemic stroke is a short- and long-term prognostic factor for stroke recurrence and subsequent manifestation of acute vascular disease. Further understanding of the pathophysiology of VBC is warranted.

One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients

2019 ◽  
Vol 47 (1-2) ◽  
pp. 40-47 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Mushtaq H. Qureshi ◽  
Li-Ming Lien ◽  
Jiunn-Tay Lee ◽  
Jiann-Shing Jeng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Large Artery ◽  
Stroke Registry ◽  
Risk Of Death ◽  
Vertebrobasilar Artery

Background: The natural history of vertebrobasilar artery (VBA) stenosis or occlusion remains understudied. Methods: Patients with diagnosis of ischemic stroke or transient ischemic attack (TIA) who were noted to have VBA stenosis based on computed tomography or magnetic resonance imaging or catheter-based angiogram were selected from Taiwan Stroke Registry. Cox proportional hazards model was used to determine the hazards ratio (HR) of recurrent stroke and death within 1 year of index event in various groups based on severity of VBA stenosis (none to mild: 0–49%; moderate to severe: 50–99%: occlusion: 100%) after adjusting for differences in demographic and clinical characteristics between groups at baseline evaluation. Results: None to mild or moderate to severe VBA stenosis was diagnosed in 6972 (66%) and 3,137 (29.8%) among 10,515 patients, respectively, and occlusion was identified in 406 (3.8%) patients. Comparing with patients who showed none to mild stenosis of VBA, there was a significantly higher risk of recurrent stroke (HR 1.21, 95% CI 1.01–1.45) among patients with moderate to severe VBA stenosis. There was a nonsignificantly higher risk of recurrent stroke (HR 1.49, 95% CI 0.99–2.22) and significantly higher risk of death (HR 2.21, 95% CI 1.72–2.83), among patients with VBA occlusion after adjustment of potential confounders. Conclusions: VBA stenosis or occlusion was relatively prevalent among patients with TIA or ischemic stroke and associated with higher risk of recurrent stroke and death in patients with ischemic stroke or TIA who had large artery atherosclerosis.

scholarly journals MRI-Based Separation of Congenital and Acquired Vertebrobasilar Artery Anomalies in Ischemic Stroke of the Posterior Circulation

Stroke ◽  
2008 ◽  
Vol 39 (8) ◽  
pp. 2382-2384 ◽  
Author(s):  
Wolfgang Freund ◽  
Jan Kassubek ◽  
Andrik J. Aschoff ◽  
Roman Huber
Keyword(s):  
Ischemic Stroke ◽  
Posterior Circulation ◽  
Vertebrobasilar Artery

Cerebral artery dissection secondary to antiphospholipid syndrome: A report of two cases and a literature review

Lupus ◽  
2020 ◽  
Vol 30 (1) ◽  
pp. 118-124
Author(s):  
Tatou Iseki ◽  
Yuri Yamashita ◽  
Yuji Ueno ◽  
Kenichiro Hira ◽  
Nobukazu Miyamoto ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Literature Review ◽  
Vertebral Artery ◽  
Antiphospholipid Syndrome ◽  
Cerebral Artery ◽  
Antiphospholipid Antibodies ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Vertebrobasilar Artery ◽  
Pubmed Database

Introduction Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by thromboembolic events, including ischemic stroke or complications in pregnancy, and the presence of antiphospholipid antibodies. Cervical artery dissection (CAD) is not an uncommon cause of stroke in young adults. The concomitant presence of APS and CAD is extremely rare. Methods Two cases with APS who developed acute ischemic strokes related to CAD are reported. A comprehensive systematic literature search using the PubMed database was also conducted. Results In Case 1, a 36-year-old woman who had been diagnosed with systemic lupus erythematosus and had been repeatedly positive for lupus anticoagulant tests developed an ischemic stroke caused by a vertebral artery dissection (VAD). After admission, she had a recurrent ischemic stroke, followed by considerable changes in steno-occlusive lesions of the vertebrobasilar artery system. In Case 2, a 36-year-old man developed multiple brain infarcts due to bilateral VAD with aneurysmal formations and associated with pulmonary embolism. The anticardiolipin antibody titer was repeatedly elevated after stroke. The literature review identified 8 patients with CAD associated with APS, involving the internal carotid artery in 6 patients and the middle cerebral artery and vertebral artery in 1 patient each. The patients were predominantly young and female, infrequently had atherosclerotic vascular risk factors, and were positive for various antiphospholipid antibodies. Conclusions The current report described two rare cases of ischemic stroke caused by CAD secondary to APS, along with a review of the literature; the patients displayed characteristic clinical manifestations, implying specific mechanisms for cerebral artery disorders secondary to APS.

Total and differential leukocyte counts in ischemic stroke caused by vertebrobasilar artery dissection

2019 ◽  
Vol 404 ◽  
pp. 101-105 ◽  
Author(s):  
Wan-Ting Chen ◽  
Feng-Chi Chang ◽  
Hui-Chi Huang ◽  
Jui-Yao Tsai ◽  
Chih-Ping Chung
Keyword(s):  
Ischemic Stroke ◽  
Artery Dissection ◽  
Vertebrobasilar Artery ◽  
Leukocyte Counts

scholarly journals Ischemic stroke with vertebrobasilar artery dissection extended to posterior cerebral artery

2017 ◽  
Vol 57 (8) ◽  
pp. 446-450
Author(s):  
Shinji Ashida ◽  
Yoshinari Nagakane ◽  
Masahiro Makino ◽  
Kei Tomonaga ◽  
Naoki Makita ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Dissection ◽  
Vertebrobasilar Artery

scholarly journals Stent Retriever Thrombectomy for Anterior vs. Posterior Circulation Ischemic Stroke: Analysis of the STRATIS Registry

2021 ◽  
Vol 12 ◽  
Author(s):  
Reza Jahan ◽  
David S. Liebeskind ◽  
Osama O. Zaidat ◽  
Nils H. Mueller-Kronast ◽  
Michael T. Froehler ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Functional Independence ◽  
Posterior Circulation ◽  
National Institutes Of Health ◽  
Good Clinical Outcome ◽  
Serious Adverse Events ◽  
Clinical Trial Registration ◽  
Vertebrobasilar Artery ◽  
Significant Difference

Background and Purpose: The benefits of mechanical thrombectomy (MT) in vertebrobasilar artery occlusions have not been well-studied. We compared clinical, procedural, and safety outcomes of MT for posterior circulation (PC) vs. anterior circulation (AC) occlusions among patients in the STRATIS registry.Methods: Data from STRATIS including patient demographics, procedural characteristics, and outcomes including symptomatic intracranial hemorrhage (sICH) at 24 h, serious adverse events (SAE), substantial reperfusion [modified thrombolysis in cerebral infarction (mTICI) 2b/3], 90-day functional independence [modified Rankin Scale (mRS) 0–2], and 90-day mortality were analyzed. Univariate logistic regression was used to calculate predictors of good clinical outcome.Results: Of 984 STRATIS patients, 43 (4.4%) patients with PC occlusions [mean age 63.0 ± 13.6, 25.6% (11/43) female] and 932 (94.7%) with AC occlusions [mean age 68.5 ± 14.8, 46.9% (437/932) female] were included for analysis. Median National Institutes of Health Stroke Scale (NIHSS) scores at baseline were 17.0 (13.0, 12.0) for the AC group and 12.0 (11.0, 24.0) for the PC group. Time from onset to procedure end was longer for the PC group [median (IQR): 322.0 min (255.0–421.0) vs. 271.0 min (207.0–360.0); p = 0.007]. PC and AC groups had similar rates of substantial reperfusion [89.2% (33/37) vs. 87.7% (684/780)], procedure-related SAE [0.0% (0/43) vs. 1.7% (16/932)], sICH [0.0% (0/38) vs. 1.5% (12/795)], 90-day functional independence [66.7% (26/39) vs. 55.9% (480/858)] and mortality [12.8% (5/39) vs. 15.8% (136/861)]. National Institutes of Health Stroke Scale score and patient sex were significant univariate predictors of good clinical outcome (p < 0.05).Conclusions: Despite longer reperfusion times, MT in PC stroke has similar rates of 90-day functional independence with no significant difference in procedure-related SAE, sICH, or mortality, supporting the use of MT in PC acute ischemic stroke (AIS).Clinical Trial Registration:https://www.clinicaltrials.gov, Identifier: NCT02239640.

Intracranial Cerebral Artery Dissection of Anterior Circulation as a Cause of Convexity Subarachnoid Hemorrhage

2015 ◽  
Vol 40 (1-2) ◽  
pp. 45-51 ◽  
Author(s):  
Kazuki Fukuma ◽  
Masafumi Ihara ◽  
Tomotaka Tanaka ◽  
Yoshiaki Morita ◽  
Kazunori Toyoda ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Border Zone ◽  
Artery Dissection ◽  
Early Reperfusion ◽  
Cerebral Magnetic Resonance Imaging ◽  
Vertebrobasilar Artery ◽  
Cerebral Artery Dissection

Background: Convexity subarachnoid hemorrhage (cSAH), defined as intrasulcal bleeding restricted to hemispheric convexities, has several etiologies: reversible cerebral vasoconstriction syndrome, cerebral amyloid angiopathy, and internal carotid artery (ICA) stenosis or occlusion. However, it remains unknown whether cerebral artery dissection causes cSAH. Methods: We retrospectively investigated patients admitted to our hospital between 2005 and 2013 with ischemic stroke or transient ischemic attack caused by cerebral artery dissection. Cerebral artery dissection was diagnosed by cervical or cerebral magnetic resonance imaging (MRI) or computed tomography (CT) showing a wall hematoma. CT angiography, ultrasonography, or intra-arterial digital-subtraction angiography detected cerebral artery dissection if a double lumen, string sign, intimal flap, or dissecting aneurysm was observed at a nonbifurcation site. We used CT or MRI to detect cSAH, which was defined as blood collection restricted to one or few cerebral sulci without extending to the basal cisterns, ventricles, or Sylvian and interhemispheric fissures. Demographic, neuroimaging, treatment, and prognostic data were collected. Results: In total, 82 patients were diagnosed with ischemic stroke caused by cerebral artery dissection. The following arteries were affected: the ICA (9 patients), anterior cerebral artery (ACA; 12 patients), middle cerebral artery (MCA; 12 patients), vertebral artery (37 patients), basilar artery (5 patients), posterior cerebral artery (2 patients), and posterior inferior cerebellar artery (4 patients). In addition, 1 patient presented with simultaneous dissection in both the vertebral and internal carotid arteries, and 6 patients (7%) presented with cSAH (3 men and 3 women, age 39-67 years). The MCA was dissected in four cases and the ACA in two cases, with cSAH frequencies of 33 (4 of 12) and 17% (2 of 12), respectively, in those vessels. Artery dissection in the vertebrobasilar artery system was not responsible for cSAH (0 of 48). In all the MCA dissection cases, cSAH occurred in the arterial border zone between the ACA and MCA territories. Although 2 patients showed early reperfusion with temporary cSAH enlargement, cSAH was self-limiting. Antithrombotic treatment did not complicate the clinical course when used in 4 patients during acute or subacute phases. All patients achieved a 3-month poststroke modified Rankin Scale of 0-2. Conclusion: Our data suggest that cSAH caused by intracranial cerebral artery dissection is not rare. Further investigations are needed to elucidate the precise mechanism underlying cSAH in cerebral artery dissection.

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