PROGNOSIS OF VERTEBROBASILAR ISCHEMIA

The pathogenesis of vertebrobasilar ischemia is not different from the one in the carotid territory. Arterio-arterial embolism from arteriosclerotic vascular lesions, local thrombosis and cardiogenic embolism are major causes. The long-term prognosis for proximal vertebral artery (VA) stenosis is dependent on associated carotid artery disease. Distal VA and basilar artery (BA) disease has a variable prognosis, which is determined by the extent of collateralization. The risk of repeated local ischemic events seems to be less than in the anterior circulation. For survivors of BA occlusion, with or without local fibrinolytic therapy, the long-term prognosis is favorable.