Basilar stroke from a persistent hypoglossal artery.

Occlusion of the basilar artery can be treated with endovascular thrombectomy, although the results have not been well studied. Persistent fetal cerebrovascular anatomy can lead to unusual presentation of carotid atherosclerotic disease and can be a barrier to successful mechanical thrombectomy if not recognized. This case presents a rare persistent carotico-basilar anastomosis which resulted in basilar occlusion via the persistent hypoglossal artery and coincident absence of contralateral vertebral arterial access due to a left vertebral artery terminating in the left posterior inferior cerebellar artery. Preoperative recognition of this anatomy afforded by review of cross-sectional imaging was critical to success during this emergent procedure.

[The efficacy of treating cerebral ischemia due to changes in the major cerebral arteries by using the preparation Tanakan (EGB 761)]. / Effektivnost' lecheniia ishemii mozga, obuslovlennoi izmeneniiami v magistral'nykh arteriiakh golovy, s ispol'zovaniem preparata "Tanakan" (EGB 761).

Cerebrovascular pathology is one of the chief causes of death. Effects were studied of the drug preparation "Tanakan" on the process of the rehabilitation of those patients (n = 150) operated on for abnormalities and deformity of brain major arteries. Two groups were identified: pathologies of the vertebral arteries (n = 50), carotid abnormalities (n = 51), control groups (n = 24 and 25 respectively). The drug was administered in a dose of 40 mg on a three-times daily schedule. Clinical approaches were used as were the dopplerographic, electroencephalographic, biochemical, micromorphological, neuropsychological methods of investigation. Determined in the study was a positive dynamics of clinical indices, which was more apparent for vertebrobasilar discirculations. EEG-investigation revealed differences in the course of changes in left- and right-hemispheric location of carotidogenous discirculations. Increase in blood serum antioxidant activity was recorded as was a positive transformation of vegetative indices and improvement of cognitive functions. Thus, the use of the above drug is indicated in the postoperative complex of rehabilitative measures in patients with cerebrovascular ischemia secondary to developmental anomalies and deformities of brain major arteries.

Symptoms of neck artery compromise: case presentations of risk estimate for treatment.

OBJECTIVE: To discuss the use of magnetic resonance angiography (MRA) imaging as a definitive means to assess vascular patency and the relative value of various vertebral artery screening maneuvers. CLINICAL FEATURES: Two female patients suffered head and neck trauma with possible vertebral artery insufficiency. Positive vertebral artery screening tests with consistent symptoms were present in both cases. One patient had a congenitally narrowed vertebral artery, whereas the second had no evidence of vascular anomaly. INTERVENTION AND OUTCOME: Conservative chiropractic management using manipulation and rehabilitation led to favorable outcome in both cases. The patient with vascular compromise received a treatment plan avoiding neck manipulation. The second case received manipulation per clinical indications from neck findings. CONCLUSION: MRA imaging may be more important to critical decision making than are the various vertebral artery screening tests in patients with positional vertigo on combined neck extension and rotation.