This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Comerota, A. J. Articles by Maurer, A. H. Search for Related Content PubMed PubMed Citation Articles by Comerota, A. J. Articles by Maurer, A. H.

Stroke, Vol 23, 602-606, Copyright © 1992 by American Heart Association

ARTICLES

Surgical correction and SPECT imaging of vertebrobasilar insufficiency due to unilateral vertebral artery stenosis

AJ Comerota and AH Maurer
Department of Surgery, Temple University Hospital, Philadelphia, Pa 19140.

BACKGROUND AND PURPOSE: Incapacitating vertebrobasilar insufficiency is generally associated with bilateral vertebral artery disease, whereas unilateral vertebral artery stenosis usually is clinically silent. Regional brain perfusion has not been part of the routine evaluation of patients with vertebrobasilar insufficiency. This report describes two patients who had isolated unilateral vertebral artery stenosis operatively corrected to eliminate their incapacitating vertebrobasilar insufficiency. Hindbrain hypoperfusion was identified preoperatively and evaluated postoperatively, then correlated with patient presentation and response to revascularization. CASE DESCRIPTION: Two patients with incapacitating vertebrobasilar insufficiency presented with isolated unilateral vertebral artery stenosis with patent, nonstenotic internal carotid arteries. Hindbrain hypoperfusion was demonstrated by iodine-123-iodoamphetamine single-photon emission computed tomography preoperatively and demonstrated significant improvement following vertebral-carotid reimplantation. The patients' symptoms resolved following revascularization. CONCLUSIONS: Although unusual, unilateral vertebral artery stenosis can cause incapacitating vertebrobasilar insufficiency. These cases demonstrate the value of imaging with single-photon emission computed tomography to evaluate regional brain hypoperfusion and to evaluate objectively the results of therapy.

This article has been cited by other articles:

				C. S. Thomas, F. Habib, K. Varghese, M. T. Abraham, N. J. Hayat, and G. Cherian Disease of Proximal Part of Vertebral Artery in Patients with Coronary Artery Disease Angiology, March 1, 2003; 54(2): 205 - 209. [Abstract] [PDF]

				N. Miyazawa, M. Uchida, A. Fukamachi, I. Fukasawa, H. Sasaki, and H. Nukui Xenon Contrast-Enhanced CT Imaging of Supratentorial Hypoperfusion in Patients with Brain Stem Infarction AJNR Am. J. Neuroradiol., November 1, 1999; 20(10): 1858 - 1862. [Abstract] [Full Text]