George B, Laurian C
Acta Neurochir (Wien). 1982;62(3-4):287-95. doi: 10.1007/BF01403636.
Bilateral vertebral angiography has been performed on 44 cases of vertebrobasilar ischaemia (VB I), excluding transient ischaemic attacks, and on 20 cases of carotid ischaemia with lesions of the vertebral artery (VA). Significant lesions (stenosis of more than 50% of the lumen and occlusion) of the VA were found in 72% of VB I and 70% of carotid ischaemia cases. In the VB I group, occlusions are as frequent as stenosis (17 occlusions and 15 stenosis); on the contrary, occlusions are half as frequent as stenosis in the carotid ischaemia group. Bilateral lesions are also more often discovered after VB I than after carotid ischaemia. Topographically, the lesions are mainly at the ostium and in the third portion of the VA. The possibility that vertebro-basilar strokes are related to significant lesions of the VA in its cervical part is emphasized. Haemodynamic disorder can explain infarcts related to bilateral lesions and some of those reported after unilateral lesions. Embolism may be suggested in cases of significant stenosis and of certain unilateral occlusions.
对44例椎基底动脉缺血（VBI，不包括短暂性脑缺血发作）患者和20例伴有椎动脉（VA）病变的颈动脉缺血患者进行了双侧椎动脉血管造影。在72%的VBI患者和70%的颈动脉缺血患者中发现了VA的显著病变（管腔狭窄超过50%及闭塞）。在VBI组中，闭塞与狭窄的发生率相同（17例闭塞和15例狭窄）；相反，在颈动脉缺血组中，闭塞的发生率是狭窄的一半。双侧病变在VBI后比在颈动脉缺血后更常被发现。从解剖位置上看，病变主要位于VA的开口处和第三段。强调了椎基底动脉卒中与VA颈部显著病变相关的可能性。血流动力学紊乱可以解释与双侧病变相关的梗死以及一些单侧病变后报道的梗死。在显著狭窄和某些单侧闭塞的病例中可能提示存在栓塞。
