What is vertebrobasilar stroke?

Updated: Mar 03, 2020
  • Author: Vladimir Kaye, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

The vertebrobasilar arterial system perfuses the medulla, cerebellum, pons, midbrain, thalamus, and occipital cortex. Occlusion of large vessels in this system usually leads to major disability or death. Vertebrobasilar stroke carries a mortality rate of more than 85%. Because of involvement of the brainstem and cerebellum, most survivors have multisystem dysfunction (eg, quadriplegia or hemiplegia, ataxia, dysphagia, dysarthria, gaze abnormalities, cranial neuropathies).

However, many vertebrobasilar lesions arise from small vessel disease and are correspondingly small and discrete. The clinical correlates of these smaller lesions consist of a variety of focal neurologic deficits, depending on their location within the brainstem. Patients with small lesions usually have a benign prognosis with reasonable functional recovery.

See the images below regarding vertebrobasilar stroke.

Lesion of the medial longitudinal fasciculus (MLF) Lesion of the medial longitudinal fasciculus (MLF) resulting in internuclear ophthalmoplegia (INO). (Courtesy of BC Decker Inc.)
Illustration of afferent (CN V) and efferent (CN V Illustration of afferent (CN V) and efferent (CN VII) limbs of the blink reflex. (Courtesy of BC Decker Inc.)
Visceral motor component of CN III and pathways in Visceral motor component of CN III and pathways involved in pupillary constriction. (Courtesy of BC Decker Inc.)
Note the horizontal eye movement. Also note a topo Note the horizontal eye movement. Also note a topographic relationship of the center for vertical gaze. (Courtesy of BC Decker Inc.)
Vestibular nuclei and their connections. (Courtesy Vestibular nuclei and their connections. (Courtesy of BC Decker Inc.)

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