Positional vertebrobasilar transient ischaemic attacks treated with vertebral angioplasty.
We report the case of a man presenting with a brain-stem stroke from which he recovered fully, who developed right-sided weakness and numbness on walking despite no demonstrable postural fall in arterial blood pressure. Angiography revealed an occluded left vertebral artery, a tight stenosis at the origin of the right vertebral artery and non-patent left posterior communicating artery. Percutaneous transluminal angioplasty to the right vertebral stenosis results in a good angiographic result, and remission of symptoms which has persisted for 1 year. Identification of such patients with vertebrobasilar positional haemodynamic symptoms due to a focal stenosis is important as angioplasty offers an effective therapeutic option.
Ruigrok
Y
Y
Department of Clinical Neuroscience, King's College School of Medicine and Dentistry and Institute of Psychiatry, London, UK.
Cox
T C
TC
Markus
H S
HS
D015901:Angiography, Digital Subtraction; D015906:Angioplasty, Balloon, Coronary; D001794:Blood Pressure / Q000502:physiology*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000628:therapy*; D016138:Walking / Q000502:physiology*