Stroke; a journal of cerebral circulation
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Correlation of MRI findings with various vascular pathologies has rarely been attempted in patients with lateral medullary infarction (LMI). The aim of the present study was to correlate the diverse MRI lesions with the vascular lesions seen on conventional cerebral angiography in LMI. ⋯ Our data suggest that the heterogeneous MRI lesions (and consequent clinical syndromes) of LMI are correlated with diverse angiographic findings, which in turn are due to different pathogenic mechanisms: etiology, location and size of the involved vessels, speed of the lesion development, and status of collateral channels. Generally, infarcts related to multiple vessel involvement, dissection, and poor collateral circulation are larger than those associated with single-vessel disease, long-standing atherothrombosis/cardiac embolism, and good collateralization.
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Vertebrobasilar dolichoectasia (VBD) may produce symptoms by direct compression of cranial nerves or the brain stem, by obstructive hydrocephalus, or by ischemia in the vertebrobasilar arterial territory. This study was undertaken to examine and characterize clinical and imaging findings in patients with stroke associated with VBD and compare these data with those for patients with VBD who did not have a stroke. ⋯ In patients with VBD, superimposed atheromatous changes of the posterior circulation may have an important role in precipitating ischemia. However, other factors related to the severity of the dolichoectasia also favor ischemia and in some cases are the only factors responsible.