Vertebrobasilar Stroke

Excerpt

Vertebrobasilar strokes are interruptions of blood flow to the posterior circulation. While these types of strokes are relatively uncommon, they are a disproportionate cause of morbidity and mortality compared to anterior circulation strokes due to discreet symptoms that resemble non-stroke medical conditions. Patients with sudden interruption of a vertebrobasilar stroke often present with the main complaint of nausea or vertigo, which can delay appropriate neurological evaluation and prevent time-dependent interventions. The vertebral and basilar arteries are the main blood vessels that supply the brainstem composed of the midbrain, pons, and medulla. These types of strokes require a specialized interdisciplinary team composed of neurologists, radiologists, emergency physicians, specialized nurses, neurosurgeons, and therapists to diagnose, treat, and effectively manage. A brainstem lesion can be localized by observing the presence of "crossed paresis," which is ipsilateral facial paralysis with contralateral limb hemiparesis and cranial nerve deficits.