Bogousslavsky J, Gates P C, Fox A J, Barnett H J
Neurology. 1986 Oct;36(10):1309-15. doi: 10.1212/wnl.36.10.1309.
We studied 17 patients with atherosclerotic bilateral occlusion of vertebral arteries (VA) identified by angiography. Seven had vertebrobasilar TIAs, eight a brainstem stroke (severe in two), and two had only carotid symptoms. Brainstem strokes were more frequent with bilateral intracranial occlusion (60%) than with at least one extracranial occlusion (28.6%), but long-term prognosis did not differ in these two groups. In follow-up, the mortality rate was 4.5% per year, and the stroke rate was 1.8% per year. Major functional disability was seen in 16.7% of the survivors. Bilateral distal VA occlusion may sometimes have a better prognosis than previously assumed. These findings raise doubts about the value of extra-intracranial surgical bypass procedures in patients with these lesions.
我们研究了17例经血管造影确诊为双侧椎动脉（VA）粥样硬化闭塞的患者。其中7例有椎基底动脉短暂性脑缺血发作（TIA），8例发生脑干卒中（2例为重症），2例仅有颈动脉症状。双侧颅内闭塞患者发生脑干卒中的频率（60%）高于至少有一处颅外闭塞的患者（28.6%），但这两组的长期预后并无差异。随访期间，年死亡率为4.5%，年卒中率为1.8%。16.7%的幸存者出现严重功能残疾。双侧椎动脉远端闭塞有时预后可能比之前认为的要好。这些发现对患有这些病变的患者行颅内外手术搭桥术的价值提出了质疑。
