Vertebral-basilar stroke (stroke in the back of the brain)


Description

A stroke is an injury to the brain from insufficient blood flow resulting in brain death. The vertebral-basilar artery supplies the cerebellum and mid brain. A stroke in this area causes balance problems, room spinning, double vision and difficulty speaking. These blood vessels can be blocked by atherosclerosis, an arterial dissection, or an embolus (a blood clot from the heart that breaks loose and lodges in the vertebral or basilar artery). Atrial fibrillation is the most cause of emboli travelling from the heart to an artery.

Symptoms

Room spinning (vertigo), double vision, incoordination, problems swallowing, difficulty speaking, weakness.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. A CTA (a type of CT scan) or MRA (a type of MRI) of the head and neck will usually be done to establish the diagnosis.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Magnetic resonance imaging (MRI), X-ray

Other Specific Tests: Echocardiogram, CTA of the neck, MRA of the neck, PT (Protime), PTT (Partial Thromboplastin Time)

Specialists:
Neurology

Treatment

Treatment depends on the size of the stroke, the timing of the symptoms, and co-existing illness of the patient. Therapy may include: anti-platelet medications (aspirin, clopidogrel/Plavix), heparin, and/or thrombolytics. Thrombolytics or clot busting medications can only be given if patients are diagnosed within several hours of their first symptoms. Prevention of the disorder involves controlling blood pressure, treating elevated cholesterol, and not smoking.
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