Embolism from vertebral artery origin occlusive disease

Area of Science:

• Neurology
• Vascular Neurology
• Cerebrovascular Disease

Background:

• Vertebral artery (VA) origin disease is a significant cause of posterior circulation stroke.
• Atherosclerosis is a common pathology affecting the VA origin.
• Intracranial embolism from VA lesions can lead to vertebrobasilar territory infarcts.

Purpose of the Study:

• To describe the clinical and angiographic features of patients with severe VA origin disease and posterior circulation embolism.
• To identify the common embolic sites and resulting infarct patterns.
• To compare the characteristics of VA origin atherosclerosis with internal carotid artery origin atherosclerosis.

Main Methods:

• Retrospective case series of 10 patients with severe VA origin occlusive disease.
• Clinical presentation, neuroimaging (angiography), and stroke locations were analyzed.
• Comparison of risk factors and demographics with internal carotid artery disease.

Main Results:

• Seven patients had complete VA occlusions; three had severe atherostenosis.
• Most common embolic sites were the VA-posterior inferior cerebellar artery region (8) and distal basilar artery (BA) (7).
• Cerebellar infarction was the most frequent clinical presentation; pontine infarction occurred in two patients due to BA embolism.

Conclusions:

• Severe VA origin atherosclerosis can lead to significant posterior circulation strokes through intra-arterial embolism.
• VA origin disease shares risk factors and embolic mechanisms with internal carotid artery origin disease.
• Understanding these similarities is crucial for stroke prevention and management strategies.