Vertebrobasilar Disease Health Article

Recovery and rehabilitation

Recovery is variable depending on the degree of occlusion in the vertebrobasilar circulation. Persons with the severe form, basilar artery occlusion, often die in 75–85% of cases. Rehabilitation depends on the extent of damage and the deficits caused by permanent injury in the brain.

Clinical trials

Research in this area is diversified and abundant. Currently, the National Institute of Neurological Disorders and Stroke (NINDS) is investigating molecular mechanisms associated with neuronal injury. Research concerning the genetics of stroke and gene therapy is ongoing in experimental models. New research in high resolution neuroimaging techniques, and rehabilitation have demonstrated compensatory mechanisms (re-circuitry of neurons) as a result of stroke. Further information can be found at <http://www.clinicaltrials.gov>. or <http://www.ninds.nih.gov>.

Prognosis

Vertebrobasilar TIAs have a favorable outcome since the chance for complete stroke is minimal. Collateral circulation from smaller blood vessels may help to improve the outcome.

Special concerns

Clinicians must be vigilant to be suspicious of vertebrobasilar insufficiency in elderly patients who suffer from vertigo. Hemorrhage has to be ruled out before blood thinner (anticoagulation) treatment is initiated. Additionally, it is important to take special precautions when feeding persons with brain stem infarction, because patients can develop problems with normal swallowing mechanisms that can cause aspiration pneumonia (caused by food lodged in the lungs).

BOOKS

Goldman, Lee, et al. Cecil's Textbook of Medicine, 21st edition. Philadelphia: W. B. Saunders Company, 2000.

Noble, John, et al. Textbook of Primary Care Medicine, 3rd edition. St. Louis: Mosby, Inc., 2001.

WEBSITES

Henry Ford Hospital Vertebrobasilar Circulatory Disorders. (April 27, 2004). <http://www.henryfordhealth.org/12470.cfm>.

ORGANIZATIONS

National Stroke Association. 9707 E. Easter Lane, Englewood, CO 80112. (303) 649-9299 or (800) STROKES; Fax: (303) 649-1328. <http://www.stroke.org>.

Laith Farid Gulli, MD

Alfredo Mori, MBBS

Nicole Mallory, MS, PA-C