title: Unexpected preserved brain perfusion imaging despite severe and diffuse atherosclerosis of supra-aortic trunks.
abstract: We report an unusual case of a patient whose whole cerebral circulation was supported by poor vicariate collaterals and a severely atherosclerotic right vertebral artery, with no brain perfusion abnormalities. Our belief is that despite the brain imaging and the absence of symptoms, because of his critical vascular disease and the paucity of data from large randomised clinical trials on vertebra-basilar revascularisation, the case required an extremely cautious approach regarding any kind of revascularisation. An accurate imaging analysis together with clinical features allowed us to decide on a strategy based on optimal medical therapy and careful clinical monitoring.
authors.affiliation: Division of Cardiology, Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II University, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gargiulo
authors.forename: Fabio
authors.initials: F
authors.lastname: Tortora
authors.forename: Mario
authors.initials: M
authors.lastname: Cirillo
authors.forename: Cinzia
authors.initials: C
authors.lastname: Perrino
authors.forename: Gabriele Giacomo
authors.initials: GG
authors.lastname: Schiattarella
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Esposito
mesh_terms: D050197:Atherosclerosis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D002317:Cardiovascular Agents / Q000627:therapeutic use; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D003097:Collateral Circulation; D004359:Drug Therapy, Combination; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D013349:Subclavian Steal Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D002317:Cardiovascular Agents