Symptoms and Signs in Early Vertebrobasilar Territory Stroke

  • L. R. Caplan
Conference paper


Within the posterior circulation, as in the anterior circulation, most acute brain infarcts are caused by thrombi within intracranial arteries. These thrombi can form in situ (“thrombosis”) within the intracranial arteries or represent emboli that have arisen from the heart, aorta, or proximal cervicocranial arteries. The possible exception is infarction in the distribution of single penetrating or circumferential branch arteries; such infarctions are often caused by luminal compromise by plaques and changes within the vessel walls [1]. Individuals of Japanese, Chinese, and Thai origin and African-Americans are more likely to have occlusive changes within intracranial posterior circulation arteries and branches, especially the distal basilar artery and the posterior inferior cerebellar arteries (PICAs), than are comparable Caucasian populations [2,3]. Thrombolysis is likely to have a different effectiveness in patients who have emboli to previously normal intracranial arteries (the entire intraluminal lesion representing a thrombus) compared to those patients that have important prior luminal narrowing caused by plaque (the occlusive lesion representing plaque plus thrombus). In this chapter, I concentrate on reviewing the clinical symptoms and signs in patients with acute occlusions of the intracranial vertebral arteries (ICVAs) and the basilar artery (BA), because they are the patients in whom thrombolysis is most likely to be feasible and therapeutically successful, and contrast the findings in patients with ICVA and BA occlusion to those found in patients with atheromatous branch disease and lacunar infarction.


Basilar Artery Posterior Inferior Cerebellar Artery Contralateral Limb Sixth Cranial Nerve Palsy Basilar Artery Occlusion 
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Copyright information

© Springer-Verlag Tokyo 1995

Authors and Affiliations

  • L. R. Caplan
    • 1
  1. 1.Department of NeurologyTufts-New England Medical CenterBostonUSA

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