Stroke/VBA

Question 1

mean age of pts. affected by VAS assosiated w manipulation

Answer 1

47.9 years old

females may be more affected

Question 2

where do most cases of aditional arterial thrombosis occur in VAS patients

Answer 2

Carotid artery in elderly

Question 3

mechanisms of vascular insuffiency

Answer 3

1. vert artery insufficieny _ due to occlusion of 1 or both
2. Arterial wall damage (intimal tear) or (intimal tear with embolic formation)
3. Vessel wall dissection- redduces bf and can produce clots
4. perivascular bleeding

Question 4

What are the two onset times and what causes it

Answer 4

1. vasoconstriction/ Embolism- Results in immediate onset of symptoms
2. Thrombosis- result in onset in hours to days

Question 5

3 sites of vertebral artery compression

Answer 5

1. bw C0-1 (contralat to rot)
2. bw C1-2
3. Bw C2-3 (ipsilat rot)

Question 6

4 major risk factors for VAS

Answer 6

1. hypertension
2. Smoking
3. Oral contraceptives
4. Migranes

Question 7

Fibromuscular dysplasia account for what % of Vas cases

Answer 7

25%

Question 8

What are the 5 d’s and 3 N’s

Answer 8

diplopia (double vis)
drop attack (fainting)
Dizziness
Dysarthria (slurred speach)
Dysphagia (swallowing difficulties)

Ataxia (uncoordiated mvmt)

Numbness
Nystagmus (invol eye mvmts)
Nausea

Question 9

How is traumatic thrombosis of a vertebral artery diagnosed

Answer 9

Using MRA

Question 10

What does PICA blockages result in

Answer 10

associated with numbness on 1 side of the body

Question 11

What is pontine artery blockage associated with

Answer 11

Associated with paralysis

Question 12

3 main causes of vertebrobasilar artery dissection (most to least)

Answer 12

1. Iatrogenic
2. Neck manip
3. Trauma