Abstract
Background: Transcranial color-coded sonography (TCCS) is used as a real-time tool to evaluate patients suspected of having vertebrobasilar insufficiency (VBI). However, the sonographic criteria for VBI remain inconclusive. The purpose of this study was to analyze the velocity in the vertebrobasilar system, which links the risk for posterior circulation infarction (POCI) and total ischemic stroke (TIS) in patients with VBI. Methods: Patients’ data were retrospectively reviewed if they were suspected of having VBI within a 2-year period. Baseline characteristics, brain images, and a series of sonography data were recorded and analyzed. We compared vertebrobasilar (VB) velocities in different age groups and in patients with infarctions. Results: A total of 875 patients were enrolled, with 112 and 427 candidates in the POCI and TIS groups, respectively. The mean velocity (MV)s of BA and bilateral VAs were all negatively correlated with age (all p < 0.001). The adjusted odds ratio was 2.55 (1.58–4.13, p < 0.001) in POCI and 1.75 (1.15–2.67, p = 0.009) in TIS if the mean velocity of the VB arteries was below 15 cm/s. Conclusions: Low VB velocity detected in TCCS was more commonly associated with ageing-related changes and a higher risk of both POCI and TIS. Recognition and aggressive treatment for these patients are necessary.
Highlights
Dizziness is the most frequent symptom among patients with posterior circulation infarction (POCI) [1,2]; it is a typical warning symptom for vertebrobasilar ischemia or vertebrobasilar insufficiency (VBI) [3–5]
We found that patients with clinically diagnosed VBI
We found that the mean velocity (MV) of basilar artery (BA) and bilateral vertebral artery (VA) were all negatively correlated with age (Table 2); there was a positive correlation between pulsatility index (PI) and age in all three vessels
Summary
Dizziness is the most frequent symptom among patients with posterior circulation infarction (POCI) [1,2]; it is a typical warning symptom for vertebrobasilar ischemia or vertebrobasilar insufficiency (VBI) [3–5]. VBI has been identified since 1945 as a syndrome of intermittent transient ischemic attacks involving posterior circulation [2,6]. The spells of ischemia result from insufficient blood flow to the brain, either in the vertebral or basilar arteries [4]. Transcranial color-coded sonography (TCCS) is used as a real-time tool to evaluate patients suspected of having vertebrobasilar insufficiency (VBI). The purpose of this study was to analyze the velocity in the vertebrobasilar system, which links the risk for posterior circulation infarction (POCI) and total ischemic stroke (TIS) in patients with VBI. Brain images, and a series of sonography data were recorded and analyzed.
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