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Posterior circulation ischaemic stroke—a review part I: anatomy, aetiology and clinical presentations

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Abstract

Posterior circulation ischaemia is a clinicopathological condition with complex symptomatology associated with an infarction within the vertebrobasilar arterial system. Posterior circulation strokes account for about 20–25% of all ischemic strokes and remain a significant cause of patient disability and mortality. Diagnosis can be challenging because presenting symptoms are often non-focal and because there is a substantial overlap in symptoms and signs of ischaemia in the anterior circulation. Despite better imaging techniques, diagnosis and treatment of life-threatening conditions, such as basilar artery occlusions, are often delayed. Therefore, early detection of symptoms and causes of posterior circulation ischaemia is essential for choosing the most appropriate therapy. In this review, we summarise the anatomy, aetiology, typical presentations and characteristic findings of common strokes resulting from disease in the vertebrobasilar arterial system.

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Authors and Affiliations

  1. Division of Neurology with Stroke Unit, Department of Neurosciences, A.O. “San Pio”, P.O. “G. Rummo”,, Via Dell’Angelo 1, 82100, Benevento (BN), MS, Italy

    Marco Sparaco

  2. Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile S. Agostino-Estense, Modena University Hospital, Baggiovara, LC, Italy

    Ludovico Ciolli

  3. UOC Neurologia e Rete Stroke metropolitana, Ospedale Maggiore, IRCCS Istituto di Scienze Neurologiche di Bologna, Bologna, AZ, Italy

    Andrea Zini

Authors
  1. Marco Sparaco
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  2. Ludovico Ciolli
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  3. Andrea Zini
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Contributions

Dr. Sparaco: study design, manuscript drafting/revising, study supervision.

Dr. Ciolli, Dr. Zini: manuscript drafting/revising.

Corresponding author

Correspondence to Marco Sparaco.

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Conflict of interest

Marco Sparaco reports no disclosures.

Ludovico Ciolli reports no disclosures.

Andrea Zini reports received consultancy and speaker fees from Boehringer-Ingelheim, Medtronic, Stryker and Daiichi Sankyo.

We performed a review of the literature about the state of art of vertebrobasilar stroke; therefore, our work did not involve neither human participants nor experiments on animals.

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Sparaco, M., Ciolli, L. & Zini, A. Posterior circulation ischaemic stroke—a review part I: anatomy, aetiology and clinical presentations. Neurol Sci 40, 1995–2006 (2019). https://doi.org/10.1007/s10072-019-03977-2

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  • DOI: https://doi.org/10.1007/s10072-019-03977-2

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