# 18 Vertebrobasilar Stroke

![](https://f001.backblazeb2.com/file/wikiFiles/183B21D1-6037-4F71-9F34-89C75024E78A.jpg)

* vertebral artery off from subclavian artery
* supply brainstem

![](https://f001.backblazeb2.com/file/wikiFiles/88C9E208-0779-440B-8EA8-F10CFE603339.jpg)

## Rare Stroke Syndromes

### SCA

![](https://f001.backblazeb2.com/file/wikiFiles/0824B47D-E599-4580-8204-464181BCE5D1.jpg)

* Ipsilateral ataxia: won't be able to flip hands back and forth, touch nose

### Basilar

![](https://f001.backblazeb2.com/file/wikiFiles/B685E164-0152-473B-8F06-10BB524E5A77.jpg)

* both sides of body, arms, legs, face
* can feel and see world but can't respond
* vegetative: can't process world around. Motor intact

### Central Pontine Myelinolysis

![](https://f001.backblazeb2.com/file/wikiFiles/FEF5BC49-6200-4352-84CA-AC8DD5E1CBEA.jpg)

### Top of Basilar

![](https://f001.backblazeb2.com/file/wikiFiles/894B5B8A-4C22-444B-B0C2-03861D32BBBE.jpg)

* Confusions, coma, eye symptoms only

## Key Syndromes

![](https://f001.backblazeb2.com/file/wikiFiles/9120D236-0DD8-4B5D-A60F-522CD0705B9B.jpg)

### AICA

![](https://f001.backblazeb2.com/file/wikiFiles/1CB75449-E388-4EA7-8EDC-0A68E529BE87.jpg)

#### Horner

![](https://f001.backblazeb2.com/file/wikiFiles/DCB22F3A-B36A-4E28-AEDF-39FE25556442.jpg)

* from hypothalamus to T1: cross medulla/pons
* might not say miosis but unequal pupils

### PICA

![](https://f001.backblazeb2.com/file/wikiFiles/A3C57946-FAA8-4841-9CE1-D1544E12CCCB.jpg)

* Nucleus Ambiguous unique to PICA

### ASA

![](https://f001.backblazeb2.com/file/wikiFiles/7F3AD857-2B56-4325-997F-51D025E1B6CE.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/DCE7C1DC-032C-4B91-857B-97DEB26FAA0A.jpg)

* bilateral paralysis below lesion, decreased sensation below lesion except for vibration/proprioception

![](https://f001.backblazeb2.com/file/wikiFiles/FB2B2C79-ED24-4EB1-A2FE-626982281786.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/266DA3CE-3E35-49AB-A687-4FB5BF41F9B8.jpg)