[The significance of distal obstructions and stenoses of the vertebral artery].

3 patients with intracranial infarctions as consequence of obstructive lesions of the distal vertebral artery are presented. The first patient, with a unilateral occlusion of the distal intracranial portion of the vertebral artery and contralateral high grade stenosis at the same site, suffered bilateral cerebellar infarctions. Predominantly occipital infarction occurred in the second patient, with unilateral occlusion of the vertebral artery, the infarction being probably caused by embolization from the distal stump. In the third patient traumatic injury of the vertebral artery at the C1/C2 level was followed by embolic occipital lobe infarction. The discussion covers pathogenetic significance of hemodynamic and thromboembolic factors for cerebellar and occipital infarctions and the possible therapeutic options.