vertebrobasilar stroke
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Etiology
- embolism, embolic stroke (largely from heart) 40%
- large artery disease 32%, arteritis, giant cell arteritis[4]
- penetrating artery disease 14%
Pathology
- vascular occlusive lesions
- symptoms attributable to ischemia of:
- supplied by:
Clinical manifestations
- dysarthria
- vertigo
- ataxia
- diplopia[3]
- visual field loss[3]
- perioral paresthesias
- acute confusional state
- profound general weakness
- focal neurologic signs[3]
- hypertensive urgency -> hypertensive crisis[3]
- gaze-evoked nystagmus
- head-thrust test negative
Complications
Management
- see ischemic stroke
- lower blood pressure with labetalol[3]
Prognosis:
- 30 day morbidity & mortality
- 4% mortality
- 18% major disability
- 51% minor disability
- 28% without disability
- poor outcomes associated with embolism
- 29% of embolic strokes
- 14% of large artery strokes
- 13% of penetrating artery strokes
- poor outcomes associated with basilar artery lesions
More general terms
Additional terms
References
- ↑ Journal Watch 22(8):62, 2002 Gass TA et al, Arch Neurol 59:369, 2002 Barnett HJM, Arch Neurol 59:359, 2002
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1021-22
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019 - ↑ 4.0 4.1 NEJM Knowledge+ Question of the Week. July 19, 2016 http://knowledgeplus.nejm.org/question-of-week/730/
- ↑ 5.0 5.1 Medical Knowledge Self Assessment Program (MKSAP) 19. American College of Physicians, Philadelphia 2021
- ↑ 6.0 6.1 NEJM Knowledge+