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Updated: Jun 24, 2026
08:22
Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
[Vertebrobasilar occlusions : Pathophysiology, diagnostics and treatment].
1Klinik und Poliklinik für neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland. fiehler@uke.uni-hamburg.de
Der Radiologe
|March 14, 2009
Summary
Acute vertebrobasilar occlusions (VBO) are life-threatening emergencies. Prompt diagnosis and endovascular treatment are crucial for improving outcomes in posterior circulation stroke.
Area of Science:
- Neurology
- Vascular Medicine
- Interventional Neuroradiology
Context:
- Acute vertebrobasilar occlusions (VBO) carry a high mortality rate (up to 90%) with standard medical care.
- Immediate diagnosis of vessel status is critical upon suspicion of VBO.
Purpose:
- To review the clinical and pathophysiological details essential for decision-making in acute VBO management.
- To highlight the diagnostic equivalence of CT/CTA and MRI/MRA in the emergency setting.
- To discuss endovascular treatment as the established therapy for posterior circulation VBO.
Summary:
- CT/CTA and MRI/MRA are equivalent diagnostic tools for acute VBO.
- Endovascular therapy is preferred for posterior circulation VBO, especially with residual stenosis after fibrinolysis.
- Systemic fibrinolysis followed by transport for local therapy ('drip and ship') is an option when neurointerventional centers are not immediately accessible.
Impact:
- Emphasizes the importance of profound clinical and pathophysiological knowledge for optimal neurointerventional therapy.
- Aims to guide clinicians in making critical treatment decisions for acute VBO.
- Contributes to improving patient outcomes in severe stroke cases.
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