Surgical treatment of the acute stroke caused by proven vertebral-basilar artery insufficiency.

Five patients with acute strokes caused by proven vertebral-basilar artery insufficiency had restoration of acutely lost neurologic function with revascularization of ischemic tissue and cells of the hindbrain, including upper and lower motor neurons of the brainstem. This was done with an operation to correct partial extralumenal obstruction of the proximal vertebral artery. The operations were performed three to seven days after the onset of the acute strokes. Patient selection is dependent on angiography of the aortic arch with visualization of the vessels of the neck, the vertebral and carotid arteries. There was no mortality and no significantly morbidity among these patients.