Stroke in the Vertebrobasilar system: Understanding causes, remedies, and prognosis
Vertebrobasilar (VB) strokes, a less common but potentially severe type of stroke, affect the brainstem and the posterior parts of the brain supplied by the vertebral and basilar arteries. These strokes account for a significant proportion of all strokes in the United States.
Common Symptoms
Symptoms of a VB stroke can be disconcerting, often including vertigo and dizziness, changes in hearing, abnormal eye movements, loss of muscle coordination, weakness, often on one side of the body, and possible difficulty with swallowing and breathing if brainstem functions are involved. Other symptoms may include headaches, vomiting, nystagmus (involuntary eye movement), and gait ataxia (loss of balance and coordination).
Causes
VB strokes are typically caused by vascular pathologies in the vertebral arteries, such as atherosclerosis, artery dissections, other vessel abnormalities like fibromuscular dysplasia, and blood clots (thrombi) that can cause ischemia in these territories.
Treatment Options
Treatment options depend on the stroke type and severity. For ischemic VB strokes caused by clots, emergency thrombolysis (clot-dissolving medication) is given within a few hours of symptom onset to restore blood flow. Acute endovascular therapies may be used, such as catheter-based removal or delivery of clot-dissolving agents directly to the clot.
If a hemorrhagic stroke occurs, surgery and medications aim to stop bleeding and reduce brain pressure. Supportive care often includes breathing assistance and management of swallowing difficulties to prevent pneumonia. Rehabilitation including vestibular therapy may be started early to help recovery from vertigo and balance issues. Anticoagulation and antiplatelet therapies can be used long-term to prevent recurrence, especially if arterial disease or thrombi are involved.
Post-Treatment Care
After treatment, a person may require rehabilitation with physical, occupational, and speech therapists. A person with a VB stroke requires care from a team specializing in stroke care, which may include neurologists, neurosurgeons, and neuro-intensivists.
Risk Factors
Risk factors for a VB stroke include high blood pressure, diabetes, cigarette smoking, obesity, irregular heart rhythm, a sedentary lifestyle, high cholesterol, illegal drug use, and high blood pressure.
Outlook
The outlook after a VB stroke can depend on several factors, including the severity of the stroke, the treatment provided, the prior baseline function of the brain, a person's age, and a person's ability to undergo physical therapy.
In summary, prompt emergency treatment and specialized aftercare are critical to improve outcomes for individuals experiencing a VB stroke. Understanding the symptoms, causes, and treatment options can help individuals seek timely medical attention and improve their chances of recovery.
Other medical-conditions, such as neurological-disorders like Parkinson's disease, epilepsy, or multiple sclerosis, might exacerbate symptoms or complicate post-stroke recovery in individuals suffering from a vertebrobasilar (VB) stroke. Every patient's health-and-wellness situation, including the presence of otherheart diseases or risk factors like diabetes or high cholesterol, should be carefully assessed during treatment and rehabilitation to provide personalized care.
