Ultrasound Diagnostics of the Vertebrobasilar System

Abstract

Despite the fact that ischemic stroke in the vertebrobasilar system (VBS) is significantly less frequent than in the carotid system, abnormalities found in Doppler and duplex examinations are about as prevalent in the VBS as in the carotid system. Because of the potentially severe clinical deficits associated with stroke of the VBS and the increased risk for stroke under conditions, such as underlying symptomatic vertebrobasilar stenosis and general anesthesia, it is highly desirable to have reliable methods available to identify pathological changes of the VBS. Furthermore, because the VBS via the circle of Willis can play a significant role as collateral blood supply system when vessels of the anterior circulation have been compromised, the knowledge of the VBS is necessary to estimate the overall integrity of the remaining blood flow to the brain.

Extracranial and Intracranial Ultrasonographic Findings in Posterior Circulation Infarction

“…17 Hemodynamic changes and stenosis detected by US are considered important indicators requiring more evaluations. [18][19][20] In this study, the US and brain magnetic resonance imaging (MRI) characteristics of the vertebrobasilar arteries in patients with posterior circulation infarction were analyzed and compared to patients with anterior circulation infarction. The clinical association between magnetic resonance angiography (MRA)-detected vascular abnormalities and US data was evaluated.…”

“…Ultrasonography (US) is an important screening tool for stroke risk factors . Hemodynamic changes and stenosis detected by US are considered important indicators requiring more evaluations . In this study, the US and brain magnetic resonance imaging (MRI) characteristics of the vertebrobasilar arteries in patients with posterior circulation infarction were analyzed and compared to patients with anterior circulation infarction.…”

Low Vertebrobasilar Velocity Is Associated with a Higher Risk of Posterior Circulation Ischemic Lesions

“…The sonographic criteria of VBI remain inconclusive, which limits the clinical application and diagnostic rate of VBI using sonography [ 9 , 15 , 16 , 17 ]. Traditionally, Spencer’s curve theory is applied to explain the hemodynamic model of vascular stenosis and flow velocity [ 18 , 19 ].…”

The use of neurovascular ultrasound versus digital subtraction angiography in acute ischemic stroke

“…This might be related to the stenosis criteria to the vertebral disease and the lower accuracy to find the vertebral artery by ultrasound 14 .…”

“…The flow velocity measurements in the intracranial evaluation were not corrected according to the incident angle 1,9,10,11 . The stenosis and occlusion of the extracranial vessels were based on previous studies 9,12,13,14 . All the DSA exams were performed by two experienced neuroradiologists (PCS, RP) blinded to the NVUE results and clinical data.…”