The natural history of internal carotid and vertebral-basilar artery occlusion

Neurology ◽  
1961 ◽  
Vol 11 (Issue 4, Part 2) ◽  
pp. 152-157 ◽  
Author(s):  
F. H. McDowell ◽  
J. Potes ◽  
S. Groch
Keyword(s):  
Natural History ◽  
Basilar Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
History Of

scholarly journals The history of basilar artery occlusion: when art aids science

2018 ◽  
Vol 76 (5) ◽  
pp. 355-357
Author(s):  
Francisco Antunes Dias ◽  
Daniel Giansante Abud ◽  
Octavio Marques Pontes-Neto
Keyword(s):  
Basilar Artery ◽  
Rare Condition ◽  
Reperfusion Therapy ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
High Morbidity ◽  
Medical Sciences ◽  
Randomized Controlled ◽  
History Of ◽  
The Impact

ABSTRACT Basilar artery occlusion (BAO) ischemic stroke is a relatively rare condition with high morbidity and mortality rates. To date, the best acute reperfusion therapy for BAO has still not been established, mainly due to the lack of randomized controlled trials in this field. In this article, we review the history of BAO diagnosis and treatment, and the impact of modern technological resources on the clinical evolution and prognosis of BAO over time. Furthermore, we describe historical events and nonmedical literature descriptions related to BAO. We conclude that BAO is a singular example of how art may help medical sciences with accurate descriptions of medical conditions.

Abstract 63: Basilar Artery Occlusion due to Vertebral or Basilar Dissection in the Basilar Artery International Cooperation Study (BASICS)

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Gabriel R de Freitas ◽  
Stefan T Engelter ◽  
Volker Puetz ◽  
Wouter J Schonewille
Keyword(s):  
Risk Factors ◽  
International Cooperation ◽  
Basilar Artery ◽  
Artery Occlusion ◽  
Vascular Risk Factors ◽  
Basilar Artery Occlusion ◽  
Vascular Risk ◽  
Prodromal Symptoms ◽  
Poor Outcome ◽  
History Of

Introduction: Since there are few reports of patients with stroke secondary to basilar artery occlusion (BAO) due to dissection, there are scarce data on its risk factors, clinical presentation, prognosis and best treatment options. Methods: The Basilar Artery International Cooperation Study (BASICS) was a large prospective, observational registry of consecutive patients who presented with an acute symptomatic BAO. We assessed clinical, radiological and therapeutical data of patients with BAO secondary to radiologically confirmed vertebral or basilar artery dissection. Stroke severity at time of treatment was dichotomized as severe (coma, locked-in state, or tetraplegia) or mild to moderate (any deficit that was less than severe). Outcome was assessed at 1 month. Poor outcome was defined as a modified Rankin scale score of 4 or 5, or death. Patients were divided into three groups according to the treatment they received: antithrombotic treatment only (AT), which comprised antiplatelet drugs or systemic anticoagulation; primary intravenous thrombolysis (IVT), including subsequent intra-arterial thrombolysis; or intra-arterial therapy (IAT), which comprised thrombolysis, mechanical thrombectomy, stenting, or a combination of these approaches. Results: In 32 (5.4%) of 592 patients with BAO, the stroke etiology was dissection. Twenty patients were men, mean age was 45.2 (± 12.7 SD) years. Fourteen patients had no vascular risk factors. Seven patients were current smokers; history of hypertension was present in 4, of dyslipidemia in 4 and other risk factors in 6 patients. Prodromal symptoms (e.g. headache, neck pain, vomiting) were present in 24 patients. History of TIA prior to BAO was recorded in 5 patients and minor stroke in 9. Twenty one patients had a progressive stroke, in 6 symptoms fluctuated and 4 presented with a maximum deficit from onset. Deficits at time of treatment were severe in 22 patients and mild to moderate in 10. Initial CT scan was normal in 9 patients, 13 had a dense basilar sign and 13 presented with early ischemic changes. In most (20) patients the BAO was in the proximal third, in 8 it was located in the distal third and in 4 in the middle third. Eleven patients were treated with only AT (3 antiplatelets, 8 anticoagulation), 9 with IVT and 12 with IA. Three patients- all treated with IA - had symptomatic hemorrhage. Overall, 18 (56%) patients had a poor outcome (AT 9 of 11, IVT 2 of 9, IA 7 of 12, p=0.03, Fisher’s exact test). Conclusions: Dissection is a rare cause of BAO that affects mainly younger patients, with few or no vascular risk factors. Patients often present with prodromal symptoms, and a progressive stroke. Initial CT changes are common and the proximal third of the basilar artery is the main localization of occlusion. As in other causes of BAO, prognosis is poor and in this registry patients treated with IVT had a lower rate of poor outcome.

Basilar Artery Occlusion: A Clinical Radiology Image

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Alahmari A ◽  
Keyword(s):  
Emergency Department ◽  
Ct Scan ◽  
Basilar Artery ◽  
Cerebrovascular Accident ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Vertebrobasilar System ◽  
Clinical Radiology ◽  
History Of ◽  
Radiology Image

A 48-year-old male patient with a history of hypertension presented to the emergency department unconscious and suspected to have a Cerebrovascular Accident (CVA). A plain CT scan was done which revealed old infarctions in multiple areas supplied by the vertebrobasilar system. The basilar artery appeared to be calcified, curved, dilated, and located outside the pontine groove. The CT scan shows occluded basilar artery see (the red arrow). The basilar artery was occluded because of the artery condition. The basilar artery occlusion is rare and it occurs in 1% of all strokes.

scholarly journals Natural History of Bilateral Internal Carotid Artery Occlusion

2013 ◽  
Vol 58 (5) ◽  
pp. 1437 ◽  
Author(s):  
Manisha J. Patel ◽  
Shannon Dodson ◽  
David Rollins ◽  
Ruth Myers ◽  
Deb Jones ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Natural History ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
History Of

Presentation and natural history of internal carotid artery occlusion

1993 ◽  
Vol 18 (3) ◽  
pp. 512-524 ◽  
Author(s):  
G. Patrick Clagett ◽  
William E. Faught ◽  
Paul S. van Bemmelen ◽  
Mark A. Mattos ◽  
Kim J. Hodgson ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Natural History ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
History Of

scholarly journals Isolated Basilar Artery Occlusion Associated with a Clivus Fracture

1989 ◽  
Vol 16 (1) ◽  
pp. 81-83 ◽  
Author(s):  
Abhijit Guha ◽  
Mahmood Fazl ◽  
Perry W. Cooper
Keyword(s):  
Basilar Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Vascular Injuries ◽  
Blunt Head Trauma ◽  
Basilar Occlusion ◽  
Clivus Fracture ◽  
Carotid Circulation ◽  
The Brain

ABSTRACT:Most vascular injuries to the brain secondary to blunt head trauma involve the internal carotid circulation. A case of isolated basilar occlusion secondary to a clival fracture is described and compared to three other cases in the literature.

Abstract W MP10: Outcome and Futile Recanalization in Basilar Artery Occlusion - Systematic Analysis

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Perttu J Lindsberg ◽  
Tiina Sairanen ◽  
Simon Nagel ◽  
Oili Salonen ◽  
Heli Silvennoinen ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Single Center ◽  
Systematic Analysis ◽  
Good Outcome ◽  
Endovascular Interventions ◽  
History Of ◽  
Stent Retrievers ◽  
The Cost

Background: Basilar artery occlusion (BAO) is a most devastating form of stroke, and the current wisdom is to reverse it with revascularization therapies. Pharmacological thrombolysis have been adjuncted or replaced with endovascular thrombectomy devices. The preferred approach remains unknown and most recanalizations are futile with no clinical benefit. Methods: To determine whether invasive, endovascular interventions are superior to pharmacological thrombolysis alone we analyzed systematically the reported outcomes produced by variable BAO recanalization protocols. Information was retrieved from 15 reports published from 2005 comprising 803 patients in 17 cohorts. In the largest single-center cohort (162, Helsinki), predictors of futile recanalization (FR;3-month modified Rankin Scale [mRS] score 4 to 6) were determined. Results: Good outcome was reported by pharmacological protocols less frequently than by mechanical approaches either alone or on-demand (24.4% vs. 35.5% %, p<0.001), accompanied by lower recanalization rates (70.9% vs. 84.1%, p<0.001)(Figure). Afforded by superior recanalization rate at 91%, good outcome was reached by primary thrombectomy with stent-retrievers in 36%, but at the cost of substantial FR rate at 60%. In the largest single-center cohort, the single most significant predictor was extensive baseline ischemia, increasing the odds of futility 20-fold (95%CI 4.39-92.29, p<0.001). Other attributes of futility were ventilation support and history of atrial fibrillation or previous stroke. Conclusion: Mechanical endovascular approaches have reported superior primary outcome rates over pharmacological thrombolysis in BAO. Stricter patient selection, most notably to exclude victims of already extended ischemia, would assist in translating excellent recanalization rates into improved clinical outcomes and more acceptable futility rates.

Presentation and natural history of internal carotid artery occlusion

1993 ◽  
Vol 18 (3) ◽  
pp. 512-524 ◽  
Author(s):  
William E. Faught ◽  
Paul S. van Bemmelen ◽  
Mark A. Mattos ◽  
Kim J. Hodgson ◽  
Lynne D. Barkmeier ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Natural History ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
History Of

Unruptured intracranial aneurysms in children: 18 years’ experience in a tertiary care pediatric institution

2019 ◽  
Vol 24 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Daniel-Alexandre Bisson ◽  
Peter Dirks ◽  
Afsaneh Amirabadi ◽  
Manohar M. Shroff ◽  
Timo Krings ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Natural History ◽  
Internal Carotid Artery ◽  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Tertiary Care ◽  
Unruptured Intracranial Aneurysms ◽  
History Of ◽  
Mean Size

OBJECTIVEThere are little data in the literature on the characteristics and natural history of unruptured intracranial aneurysms in children. The authors analyzed their experience with unruptured intracranial aneurysms in the pediatric population at their tertiary care pediatric institution over the last 18 years. The first objective was to assess the imaging characteristics and natural history of these aneurysms in order to help guide management strategies in the future. A second objective was to evaluate the frequency of an underlying condition when an incidental intracranial aneurysm was detected in a child.METHODSThe authors conducted a Research Ethics Board–approved retrospective review of incidental intracranial aneurysms in patients younger than 18 years of age who had been treated at their institution in the period from 1998 to 2016. Clinical (age, sex, syndrome) and radiological (aneurysm location, type, size, thrombus, mass effect) data were recorded. Follow-up imaging was assessed for temporal changes.RESULTSSixty intracranial aneurysms occurred in 51 patients (36 males, 15 females) with a mean age of 10.5 ± 0.5 years (range 9 months–17 years). Forty-five patients (88.2%) had a single aneurysm, while 2 and 3 aneurysms were found in 3 patients each (5.8%). Syndromic association was found in 22 patients (43.1%), most frequently sickle cell disease (10/22 [45.5%]). Aneurysms were saccular in 43 cases (71.7%; mean size 5.0 ± 5.7 mm) and fusiform in the remaining 17 (28.3%; mean size 6.5 ± 2.7 mm). Thirty-one aneurysms (51.7%) arose from the internal carotid artery (right/left 1.4), most commonly in the cavernous segment (10/31 [32.3%]). Mean size change over the entire follow-up of 109 patient-years was a decrease of 0.6 ± 4.2 mm (range −30.0 to +4.0 mm, rate −0.12 ± 9.9 mm/yr). Interval growth (2.0 ± 1.0 mm) was seen in 8 aneurysms (13.3%; 4 saccular, 4 fusiform). An interval decrease in size (8.3 ± 10.7 mm) was seen in 6 aneurysms (10%). There was an inverse relationship between aneurysm size and growth rate (r = −0.82, p < 0.00001). One aneurysm was treated endovascularly with internal carotid artery sacrifice.CONCLUSIONSUnruptured pediatric intracranial aneurysms are most frequently single but can occur in multiples in a syndromic setting. None of the cases from the study period showed clinical or imaging signs of rupture. Growth over time, although unusual and slow, can occur in a proportion of these patients, who should be identified for short-term imaging surveillance.

Endovascular Treatment for Acute Basilar Artery Occlusion: A Nationwide Prospective Registry

2019 ◽  
Author(s):  
Wenjie Zi ◽  
Zhongming Qiu ◽  
Deping Wu ◽  
Fengli Li ◽  
Hansheng Liu ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion
Sign in / Sign up

Export Citation Format

Share Document