Clinical and radiological correlation in patients with vertebrobasilar artery occlusion

Aim Although ischemic stroke in posterior stroke induces approximately one‐fifth of all strokes, basilar artery occlusion ( BAO ) and bilateral intracranial vertebral artery occlusion ( BIVAO ) are relatively rare. The present study was carried out to clarify the differences in clinical features between patients with ischemic stroke caused by BAO and BIVAO . Methods We retrospectively investigated 17 patients with ischemic stroke caused by either BAO or BIVAO who were transferred to our emergency ward within 24 hours of onset. Intravenous and intra‐arterial thrombolysis, stenting, and medications were given according to the patient's age, underlying diseases, time from onset, stroke etiology, and degree of neurological symptoms. Patient background, underlying diseases, findings on admission, prior history of stroke, prior antithrombotic treatment, sites of infarction, treatment, and outcome at discharge were compared between patients with BAO and BIVAO . Results A total of 10 patients had BAO and seven had BIVAO . The stroke etiology was significantly different between the two groups; 60% of patients with BAO had cardioembolic stroke, whereas more than 70% of cases of BIVAO were induced by large artery atherosclerosis ( P  =   0.039). Although initial neurological deficits as evaluated by the National Institute of Health and Stroke Scale score differed ( P  =   0.005), the median modified Rankin Scale became similar at discharge ( P  =   0.42). Conclusions Ischemic stroke caused by BIVAO was frequently induced by large artery atherosclerosis, whereas that caused by BAO was categorized as cardioembolic stroke. Although patients with BIVAO had less severe disease than those with BAO on admission, both groups showed poor functional outcomes at discharge.