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Review Article
Current Concepts
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Volume 352:2618-2626 June 23, 2005 Number 25
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Vertebrobasilar Disease
Sean I. Savitz, M.D., and Louis R. Caplan, M.D.

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-PubMed Citation
Eighty percent of strokes are ischemic. Twenty percent of ischemic events involve tissue supplied by the posterior (vertebrobasilar) circulation (Figure 1). The paralysis of vertebrobasilar stroke can be devastating, and some forms have high rates of death.1 Many cases of vertebrobasilar disease remain undiagnosed or are incorrectly diagnosed.2 Some common symptoms, such as dizziness or transient loss of consciousness, are misattributed to posterior-circulation ischemia. Formerly, clinicians used the catchall term "vertebrobasilar insufficiency" to indicate a hemodynamic cause of all cases of posterior-circulation ischemia.1,3,4 During the past 15 years, information provided by detailed clinical studies and brain imaging has . . . [Full Text of this Article]

Causes and Vascular Lesions

Symptoms and Signs

Common Patterns of Presentation

Embolism

Atherosclerotic Stenosis and Occlusion

Penetrating Artery Disease

Arterial Dissection

Symptoms Not Usually Caused by Posterior-Circulation Disease

Isolated Attacks of Dizziness, Light-Headedness, or Vertigo

Transient Decrease in Consciousness

Drop Attacks

Evaluation of Patients with Suspected Posterior-Circulation Ischemia

Prognosis

Immediate and Preventive Therapy

Short-Term Medical Management

Prevention

Future Directions

Endovascular Procedures

Surgery


Source Information

From the Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston.

Address reprint requests to Dr. Savitz at the Division of Cerebrovascular Disease, Department of Neurology, Palmer 127, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, or at ssavitz@bidmc.harvard.edu.


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