Skip to main content
SpringerLink
Log in

Role of computed tomography in vertebrobasilar ischemia

  • Second Part Roles of Scanning: CT, PET and MRI
  • Published:
Neuroradiology Aims and scope Submit manuscript

Summary

Precise delineation of vertebrobasilar ischemia by computed tomography (CT) appears difficult due to the numerous variations in distribution of the posterior fossa arterial supply. While pontine and upper brainstem infarctions can be readily demonstrated, medullary infarction remains beyond the scope of present CT scanners. CT findings in cases of basilar artery occlusion include bilateral pontine infarction or extensive brainstem ischemia, associated with cerebellar and posterior cerebral vascular damage. Demonstration of basilar artery occlusion using routine CT is only rarely achieved. In cerebellar ischemia, CT, in conjunction with clinical syndromes, helps in the recognition of the arterial territory involved. CT provides useful guidelines for the treatment of cerebellar stroke, leading to surgery in cases of massive cerebellar infarction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wood MV, Murphey F (1969) Obstructive hydrocephalus due to infarction of a cerebellar hemisphere. J Neurosurg 30: 260–263

    Google Scholar 

  2. Momose KJ, Lehrich JR (1973) Acute cerebellar infarction presenting as a posterior fossa mass. Radiology 109:343–352

    Google Scholar 

  3. Foix C, Hillemand P (1925) Les artères de l'axe encéphalique jusqu'au diencephale inclusivement. Rev Neurol 44:705–739

    Google Scholar 

  4. Fisher CM, Karnes WE, Kubick CS (1961) Lateral medullary infarction. The pattern of vascular occlusion. J Neuropathol Exp Neurol 20:323–379

    Google Scholar 

  5. Escourolle R, Hauw JJ, Der Agopian P Trelles L (1976) Les infarctus bulbaires. J Neurol Sci 28:103–113

    Google Scholar 

  6. Toole JF (1984) Cerebrovascular disorders, 3rd edn vol 1, Raven Press, New York

    Google Scholar 

  7. Salamon G, Huang YP (1976) Radiologic anatomy of the brain, vol. 1. Springer, Berlin

    Google Scholar 

  8. Hinshaw DB, Thompson JR, Hasso AN, Casselman ES (1980) Infarctions of the brainstem and cerebellum: A correlation of computed tomography and angiography. Radiology 137: 105–112

    Google Scholar 

  9. Fisher CM, Caplan LR (1971) Basilar artery branch occlusion: a cause of pontine infarction. Neurology 21:900–905

    Google Scholar 

  10. Lazorthes G (1961) Vascularisation et circulation cérébrales, vol. 1. Masson, Paris

    Google Scholar 

  11. Zeal AA, Rhoton AL (1978) Microsurgical anatomy of the posterior cerebral artery. J Neurosurg 48:534–559

    Google Scholar 

  12. Percheron G (1976) Les artères du thalamus humain. Artères et territoires thalamiques paramédians de l'artère basilaire communicante. Rev Neurol 132:309–324

    Google Scholar 

  13. Castaigne P, Lhermitte F, Buge A, Escourolle R, Hauw JJ, Lyon-Caen O (1981) Paramedian thalamic and midbrain infarcts: clinical and neuropathological study. Ann Neurol 10: 127–148

    Google Scholar 

  14. Guberman A, Stuss D (1983) The syndrome of bilateral paramedian thalamic infarction. Neurology 33:540–546

    Google Scholar 

  15. Barbizet J, Degos JD, Louarn F, N'Guyen JP, Mas JL (1981) Amnésie par lésion ischemique bi-thalamique. Rev Neurol 137:415–424

    Google Scholar 

  16. Greenberg JO, Smolen A, Cosio L (1982) Computerized tomography in infarctions of the vertebral — basilar system. Comput Radiol 6:149–153

    Google Scholar 

  17. Castaigne P, Lhermitte F, Gautier JC, Escourolle R, Derouesne C, Der Agopian P, Popa C (1973) Arterial occlusion in the vertebro-basilar system. A study of 44 patients with postmortem data. Brain 96:133–154

    Google Scholar 

  18. Caplan LR, Rosenbaum AE (1975) Role of cerebral angiography in vertebrobasilar occlusive disease. J Neurol Neurosurg Psychiatr 38:601–612

    Google Scholar 

  19. Archer CR, Horenstein S (1977) Basilar artery occlusion —Clinical and radiological correlation. Stroke 8:383–390

    Google Scholar 

  20. Labauge R, Pages M, Marty-Double C, Blard JM, Boukobza M, Salvaing P (1981) Occlusion du tronc basilaire. Rev Neurol 137:545–571

    Google Scholar 

  21. Caplan LR (1979) Occlusion of the vertebral or basilar artery. Follow-up analysis of some patients with benign outcome. Stroke 10:277–282

    Google Scholar 

  22. Caplan LR (1979) “Top of the basilar” syndrome, Neurology 30:72–79

    Google Scholar 

  23. Gács G, Fox AJ Barnett HJM, Vinuela F (1983) CT visualisation of intracranial arterial thromboembolism. Stroke 14: 756–762

    Google Scholar 

  24. Vonofakos D, Marcu H, Hacker H (1983) CT diagnosis of basilar artery occlusion. AJNR 4:525–528

    Google Scholar 

  25. Fisher CM (1965) Lacunes: Small deep cerebral infarcts. Neurology 15:774–784

    Google Scholar 

  26. Miller VT (1983) Lacunar stroke — A reassessment. Arch Neurol 40:129–134

    Google Scholar 

  27. Stiller J, Shanzer S, Yang W (1982) Brainstem lesions with pure motor hemiparesis. Computed tomographic demonstration. Arch Neurol 39:660–661

    Google Scholar 

  28. Rascol A, Clanet M, Manelfe C, Guiraud B, Bonafe A (1982) Pure motor hemiplegia: CT study of 30 cases. Stroke 13:11–17

    Google Scholar 

  29. Heros R (1982) Cerebellar hemorrhage and infarction. Stroke 13:106–109

    Google Scholar 

  30. Sypert GW, Alvord EC (1975) Cerebellar infarction: A clinicopathological study. Arch Neurol 32:357–363

    Google Scholar 

  31. Rubenstein RL, Norman DM, Schindler RA, Kassef L (1980) Cerebellar infarction — A presentation of vertigo. Laryngoscope XC:505–514

    Google Scholar 

  32. Hardy DG, Peace DA, Rhoton AL (1980) Microsurgical anatomy of the superior cerebellar artery. Neurosurgery 6:10–28

    Google Scholar 

  33. Duncan GW, Parker SW, Fisher CM (1975) Acute cerebellar infarction in the pica territory. Arch Neurol 32:364–368

    Google Scholar 

  34. Scotti G, Spinnler H, Sterzi R, Vallar G (1979) Cerebellar softenings. Ann Neurol 8:133–140

    Google Scholar 

  35. Taneda M, Ozaki K, Wakayama A, Yagi K, Kaneda H, Irino T (1982) Cerebellar infarction with obstructive hydrocephalus. J Neurosurg 57:83–91

    Google Scholar 

  36. Khan M, Polyzoidis KS, Adegbite ABO, Mc Quenn JD (1983) Massive cerebellar infarction: “conservative” management. Stroke 14:745–751

    Google Scholar 

  37. Shenkin HA, Zavala M (1982) Cerebellar strokes: Mortality, surgical indications, and results of ventricular drainage. Lancet 2:429–432

    Google Scholar 

  38. Gillilan LA (1964) The correlation of the blood supply to the human brain stem with clinical brain stem lesions. J Neuropathol Exp Neurol 23:78–108

    Google Scholar 

  39. Rodda R (1971) The vascular lesions associated with cerebellar infarcts. Proc Aust Assoc Neurol 8:101–109

    Google Scholar 

  40. Kinkel WR, Jacobs L, Heffner RR, Kinkel PR (1981) Pathological correlations of computerized tomographic images in cerebral ischemia and infarction in cerebrovascular diseases. Mossy J, Reinmuth OM (eds) Raven Press, New-York

    Google Scholar 

  41. Kingsley DPE, Radue EW, Du Boulay GH (1980) Evaluation of computed tomography in vascular lesions of the vertebrobasilar territory. J Neurol Neurosurg Psychiatr 43:193–197

    Google Scholar 

  42. Naidich TP, Moran CJ, Pudlowski RM, Hanaway J (1979) Advances in diagnosis: cranial and spinal computed tomography. Med Clin North Am 63:849–895

    Google Scholar 

  43. Manelfe C, Guiraud B, Bonafe A (1982) Pathologie vasculaire ischémique dans le territoire carotidien et vertébro-basilaire. Traité de Radiodiagnostic, tome 16, Radio-ophtalmologie. Masson, Paris pp 680–707

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neuroradiology, Hôpital Purpan, F-31059, Toulouse Cedex, France

    A. Bonafe, C. Manelfe & B. Scotto

  2. Department of Pathology (Pr.J.Fabre), Hôpital Purpan, F-31059, Toulouse Cedex, France

    M. Y. Pradere

  3. Department of Neurology, Hôpital Purpan, F-31059, Toulouse Cedex, France

    A. Rascol

Authors
  1. A. Bonafe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Manelfe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Scotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Y. Pradere
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Rascol
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bonafe, A., Manelfe, C., Scotto, B. et al. Role of computed tomography in vertebrobasilar ischemia. Neuroradiology 27, 484–493 (1985). https://doi.org/10.1007/BF00340844

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00340844

Key words

Search

Navigation