Purpose
To describe imaging unenhanced-CT,
CT-angiography and CT-perfusion findings in acute intracranial vertebrobasilar artery occlusion (VBO),
and correlate these data with endovascular treatment and clinical outcomes.
Methods and Materials
Fifteen patients were diagnosed with VBO in our institution between April 2010 and August 2012.
All received CT/CTA,
in wake up strokes also CTP or RM perfusion were done. All included patients had criteria of VBO,
clinical data of 15 patients were comprised of 13 male patients and 2 female patients with ages from 40 to 78 years (mean,
62.4 years).
CT scanning was obtained on a 16-row scanner.
For CTP/CT-angiography,
serial CT was performed with a rapid bolus injection of contrast material and adjacent...
Results
Five patients (33.3 %) had normal unenhanced-CT basal and all had partial or complete occlusion of the basilar artery demonstrated by CTA.
Four (26.7%) with wake up stroke received CTP.
The mean National Institutes of Health Stroke Scale (NIHSS) score at presentation was 14.5.
Six patients received thrombolytic therapy and endovascular treatment using mechanical thrombectomy.
Average time from presentation to initiation of the endovascular procedure was 6.1 hours.
The mean time for recanalization from the start of angiography was 2.99 hours; it was higher than...
Conclusion
In patients presenting with a high clinical probability of posterior circulation stroke,
unenhanced CT and CT-angiography are indicated in such circumstances to assess posterior circulation occlusion,
showing the need for urgent revascularization.
Only NIHSS score at presentation and the TICI score at the end of the procedure were entered as predictors of a good clinical outcome of acute intracranial VBO2.
Poor outcomes and high mortality rates in association with the treatment of acute VBO had been historically shown in published case series.
Neuroimaging tools provide...
References
Kashiwagi J.
Kiyosue H et al.
Endovascular recanalization of acute intracranial vertebrobasilar artery occlusion using local fibrinolysis and additional balloon angioplasty.
Neuroradiology.
2010; 52: 361-370.
Webb S.
Yashar P et al.
Treatment and outcomes of acute intracranial vertebrobasilar artery occlusion: one institution's experience.
J Neurosug.
2012; 116: 952-960.
Personal Information
Author: Aja RodrĂguez,
LucĂa
Co-authors: Rivera Sierra,
Germán Camilo; Quispe Bravo,
Jaqueline; De Miquel Miquel,
M Angels; Quesada GarcĂa,
Helena; Cardona Portela,
Pere.
Presenting author: Rivera Sierra,
Germán Camilo.