What are the risk factors for vertebrobasilar stroke?

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

Answer

Vertebrobasilar insufficiency or stroke may be caused by a number of mechanisms, including thrombus, embolism, and hemorrhage (secondary to aneurysm or trauma). [4] In general, strokes occur because of ischemic events (80-85% of patients) or hemorrhage (15-20% of patients). A number of risk factors are associated with stroke, such as the following:

A prospective study by Amin-Hanjani et al indicated that in patients with symptomatic atherosclerotic vertebrobasilar occlusive disease, angiographic evidence of low distal flow status signals a higher likelihood of subsequent vertebrobasilar stroke. The study used large-vessel quantitative magnetic resonance angiography to distinguish low from normal flow in patients who had suffered a recent vertebrobasilar transient ischemic attack or stroke and in whom at least 50% atherosclerotic stenosis or occlusion was present in vertebral and/or basilar arteries. Among patients with low distal flow status, the 12- and 24-month event-free survival rates were 78% and 70%, respectively, while in patients with normal flow, the rates were 96% and 87%, respectively. [5]

Another study by Amin-Hanjani et al indicated that in patients with vertebrobasilar disease and low blood flow, strict blood pressure control may actually raise the stroke risk. Again, the study’s patients had recently suffered a vertebrobasilar transient ischemic attack or stroke and had 50% or more atherosclerotic stenosis or occlusion of vertebral or basilar arteries. The investigators found the greatest risk of subsequent stroke to be in those individuals with a combination of low blood flow and blood pressure below 140/90 mm Hg. [6]


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