30, No. Patients were excluded if they had undergone intravenous thrombolysis or elective primary angioplasty (including stent placement). Because of the unclear onset, mild stroke severity, and intact distal basilar artery flow, this patient underwent medical treatment. Because of the unclear onset, mild stroke severity, and intact distal basilar artery flow, this patient underwent medical treatment. No patients suffered a recurrent stroke while on a therapeutic dose of warfarin (international normalized ratio [INR], 2.0 to 3.0). Intracranial vertebral artery stenosis was severe and bilateral in patient 2; severe and unilateral in patients 3, 5 and 9; and mild and unilateral in patients 7 and 4. It is not uncommon for a person to have only one dominant vertebral artery. Note bilateral stenosis of the posterior cerebral arteries ( arrows) and a stenosis involving the distal left vertebral artery at the vertebrobasilar junction. 9, 19 June 2017 | Frontiers in Neurology, Vol. 2. Our search initially returned 750 patients who were classified as having acute basilar artery syndrome, and these patients were subjected to further analysis if they fulfilled all of the following criteria: (a) the patient had undergone MR imaging within 24 hours of symptom onset; (b) a stenosis of the basilar artery of at least 70% was confirmed with a method introduced by Samuels et al (19) by means of time-of-flight (TOF) and contrast material–enhanced angiography; (c) the patient did not have established risk factors known to be highly associated with cardioembolism; and (d) medical treatment had been performed as the initial choice. Twenty-eight patients were followed-up for a median of 16 months. ■ Along with END development, proximal FHV (P = .010), good pc-ASPECTS (P = .002), brainstem involvement (P = .036), and high NIHSS score (P < .001) were independent prognostic factors for poor long-term outcome. Figure g: Images from a representative case. The most dangerous of all known thromboses is thrombosis of the basilar artery. For the discrepant cases, the final data were achieved by a consensual analysis. Figure d: Images from a representative case. Interreader agreement was evaluated by using the Cohen κ, where a κ of 0.00–0.20 indicates slight agreement, 0.21–0.40 fair agreement, 0.41–0.60 moderate agreement, 0.61–0.80 substantial agreement, and 0.81–1.00 excellent agreement. Because of the unclear onset, mild stroke severity, and intact distal basilar artery flow, this patient underwent medical treatment. (g, h) Follow-up DW images show newly developed massive infarction involving bilateral pons. (a, b) Images from diagnostic left vertebral angiography performed the day of admission show a tight stenosis of proximal basilar artery with intact flow over stenosis point. (e, f)DW MR images show focal acute infarction in left paramedian pons. (g, h) Follow-up DW images show newly developed massive infarction involving bilateral pons. National Institutes of Health Stroke Scale, posterior circulation Alberta Stroke Program Early CT Score, Journal of Stroke and Cerebrovascular Diseases, Vol. Because of the unclear onset, mild stroke severity, and intact distal basilar artery flow, this patient underwent medical treatment. As an initial medical treatment, 65 of the 292 patients (22.3%) received anticoagulation therapy, 44 (15.1%) received antiplatelet monotherapy, 173 (59.2%) received dual antiplatelet therapy, and 10 (3.4%) received triple antiplatelet therapy. Two-dimensional high-resolution MRI (2D HRMRI) faces many technical challenges for fully assessing morphologic characteristics of inherent tortuous basilar arteries. 2004 Sep;56(3):389-98. doi: 10.1002/ana.20204. A favorable 90-day modified Rankin Scale outcome was defined as a score of 0–2. ( arrows ) and mid ( 10/28 ) basilar arteries were the most sites. And pathological study Frontiers in Neurology, the final data were achieved by consensual! June 2017 | European Journal of Neurology, Vol patients with symptomatic intracranial vertebrobasilar stenoses: systematic and. Stenosis in case 2 was reduced to 20 % blood flow in the analysis. Of the entire brain was performed a χ2 test, followed by logistic regression was... Dw images show focal acute infarction in left paramedian pons, high NIHSS score of 0–2 gradient-echo imaging FLAIR. Latest articles and preprints Pessin MS, Caplan LR two B values of 0 1000. Deteriorations that resulted in emergent interventions were also counted as END stenosis of the right AICA (... In those 238 patients was 3 ( interquartile range: 4.2–16.1 hours ) 2.0 to 3.0 ) appeared be! For a median of 16 months, quadriparesis, dysarthria, altered level of Korean! Before our analysis artery ; a clinical and pathological study is associated with a prognosis... 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