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Basilar artery stenosis

Middle and distal segments

Departments of Neurology (Drs. Pessin and Caplan) and Radiology (Dr. Kwan), Tufts-New England Medical Center, Boston, MA, and the Department of Neurology (Dr. Gorelick), Michael Reese Hospital, Chicago, IL.

We report the clinical features and prognosis in nine patients with angiographically documented basilar artery stenosis of the middle and distal segments. Six patients had transient ischemic attacks (TIAs), and in two this was their only clinical manifestation. The TIAs in four patients included two or more of the following symptoms: dizziness, diplopia, perioral numbness, dysphagia, weakness, or loss of consciousness. Two other patients had isolated symptoms of transient dizziness and unilateral weakness. Seven patients had posterior circulation strokes, preceded by TIAs in four. Basilar artery occlusive disease can affect any segment of the artery. The short-term prognosis of middle and distal basilar artery stenosis was good especially when patients were treated with warfarin or platelet antiaggregants.

Address correspondence and reprint requests to Dr. Pessin, Tufts-New England Medical Center, 171 Harrison Avenue, Boston, MA 02111.

Received October 7, 1986. Accepted for publication in final form January 21, 1987.

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