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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Ischemic stroke patterns and hemodynamic features in patients with small vertebrobasilar artery
Jong-Ho Park1, Jae-Kyu Roh, Hyung-Min Kwon
1Department of Neurology, Myongji Hospital, Kwandong University College of Medicine, Goyang, Republic of Korea.
Journal of the Neurological Sciences
|August 18, 2009
Summary
Small vertebrobasilar artery (SVBA) disease in posterior circulation stroke (PCS) patients may lead to smaller infarcts due to compensatory collateral flow from the long circumferential artery (LCA). Fetal posterior circulation (FPC) does not prevent infratentorial PCS.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Posterior circulation stroke (PCS) is a significant cause of neurological disability.
- The role of small vertebrobasilar artery (SVBA) in PCS pathogenesis remains incompletely understood.
- Evaluating ischemic patterns and collateral circulation in PCS patients with SVBA is crucial.
Purpose of the Study:
- To investigate the role of SVBA in PCS.
- To analyze ischemic patterns, collateral features, and stroke mechanisms in PCS patients with SVBA.
- To compare SVBA with normal-sized vertebrobasilar artery (NVBA) in PCS.
Main Methods:
- Retrospective analysis of 18 PCS patients using magnetic resonance (MR) imaging and angiography.
- Correlation of ischemic findings with 3D time-of-flight/contrast-enhanced MR angiography and/or catheter angiography.
- Comparison of SVBA (<3 mm lumen diameter) with stenotic NVBA in 14 PCS patients.
Main Results:
- Ischemic lesions predominantly affected the cerebellum and/or medulla (vertebral artery (VA) territory).
- All patients exhibited fetal posterior circulation (FPC).
- SVBA patients showed smaller, scattered infarcts compared to those with stenotic NVBA, suggesting collateral compensation via prominent long circumferential arteries (LCAs).
Conclusions:
- Fetal posterior circulation (FPC) does not confer protection against infratentorial PCS.
- Established collaterals, particularly from the LCA, may mitigate infarct size in the infratentorial area despite extensive arterial lesions.
- SVBA may play a role in PCS by influencing infarct characteristics through collateral pathways.
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