BACKGROUND Persistent primitive hypoglossal artery (PPHA), a remnant of embryonal circulation, is a rare variant of the posterior cerebral circulation. Seven prior cases of posterior circulation stroke in the setting of PPHA have been described in the literature, with all but one case being attributable to atherosclerotic embolization from the internal carotid artery (ICA) through the PPHA. C...

Posterior circulation strokes represent approximately 20% of all ischemic strokes (1, 2). In contrast to the anterior circulation, several differences in presenting symptoms, clinical evaluation, diagnostic testing, and management strategy exist presenting a challenge to the treating physician. This review will discuss the anatomical, etiological, and clinical classification of PC strokes, iden...

Arteriogenesis for Cerebral Ischemia To the Editor: The pioneering efforts in the development of therapeutic arteriogenesis for cerebral ischemia reported by Buschmann et al1 herald a new era in the field of stroke therapy. The role of collaterals in maintaining perfusion beyond the site of a proximal arterial occlusion has long been appreciated as a critical factor in reducing ischemic injury ...

The most frequent clinical manifestation of vertebral artery dissection is posterior headache or neck pain accompanied or followed by posterior circulation transient ischemic attack or stroke. Rarer clinical features include isolated headache or neck pain, cervical spinal cord ischemia and cervical root impairment. Asymptomatic vertebral artery dissections have been reported. In the case of pri...

BACKGROUND Circle of Willis (COW) variants might influence arterial caliber in the brain. We hypothesized that these variants would be associated with the prevalence of intracranial dolichoectasia (DE). METHODS We examined COW variants and DE in a sample of stroke-free participants (n = 436) undergoing magnetic resonance angiography (MRA) as part of a population-based study. Large intracrania...

Background. Vertebrobasilar insufficiency (VBI) is a hemodynamic posterior circulation transient ischemic attack (TIA) caused by intermittent vertebral artery occlusion that is induced by a head rotation or extension. VBI may result from large vessel atherosclerotic disease, dissection, cervical compressive lesions, and subclavian steal phenomenon. Diagnostic transcranial Doppler (TCD) of VBI d...

Posterior circulation revascularization is a challenging technique because microanastomosis must be performed in deep locations. A reproducible simulation model is proposed for training. The prototype three-dimensional skull model with artificial brain was used. The mesencephalic segment of superior cerebellar artery (SCA) and the caudal loop of the posterior inferior cerebellar artery (PICA) w...

Circulation We read with interest the article by Isokangas et al about endovascular treatment of peripheral aneurysms of the posterior inferior cerebellar artery (PICA). We agree with the authors that most peripheral aneurysms seem secondary to arterial dissection and can be treated by endovascular techniques. We have recent experience in treating 2 consecutive cases of patients with peripheral...

The results of surgery on multiple intracranial aneurysms tha involve the vertebrobasilar circulation are poor, and associated patient mortality remains high. We describe the endovascular treatment of four patients with mutiple aneurysms that involved the posterior intracrancial circulation. Satisfactory occlusion of all aneurysms was achieved by using electrolytically detachable coils, and all...