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Background: Acute basilar artery occlusion is a disabling and life-threatening condition. The purpose of this study was to evaluate the impact of occluded vessel location on the prognostic outcomes of patients who underwent endovascular treatment for acute basilar artery occlusion.
Methods: Patient data for this study were obtained from the ATTENTION registry. Baseline data of the patients were described and compared across different occlusion locations. Univariable and multivariable regression analyses were performed to assess the effect of occluded vessel location on associated prognostic outcomes.
Results: A total of 1672 patients were included in the analysis, with 583 having distal occlusion, 540 having middle occlusion, and 549 having proximal occlusion. Unlike distal occlusion, both proximal and middle occlusions were significantly and negatively associated with favorable clinical outcomes (for modified Rankin Scale score 0-3: adjusted odds ratio (aOR) 0.634, 95% confidence interval (95% CI) 0.493 to 0.816, P<0.001 in middle occlusion, and aOR 0.620, 95% CI 0.479 to 0.802, P<0.001 in proximal occlusion). Mortality was higher in patients with proximal and middle occlusions (aOR 1.461, 95% CI 1.123 to 1.902, P=0.005 in middle occlusion, and aOR 1.648, 95% CI 1.265 to 2.147, P<0.001 in proximal occlusion). The occluded vessel location was not associated with symptomatic intracranial hemorrhage.
Conclusions: Proximal and middle basilar artery occlusions were predominantly associated with poor clinical outcomes and increased risk of death following endovascular treatment.
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http://dx.doi.org/10.1136/jnis-2023-020517 | DOI Listing |
Cureus
August 2025
Department of Internal Medicine, Local Health Unit of Santa Maria, Lisbon, PRT.
Polyarteritis nodosa (PAN) rarely affects both intracranial and mesenteric arteries. Evidence on optimal timing of revascularisation and the role of interleukin-6 blockade remains limited. A 73-year-old man with longstanding ankylosing spondylitis presented with weight loss and elevated inflammatory markers.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
September 2025
Department of Neurosurgery, Hospital East-Limburg, Genk, Limburg, Belgium.
Background: Calcium pyrophosphate dihydrate (CPPD) deposition disease at the craniocervical junction (CCJ) typically presents with a retro-odontoid pseudotumor. Here, the authors report a case of CPPD-induced basilar impression, causing vertebral artery (VA) dissection and hemorrhage.
Observations: A 65-year-old male presented with worsening chronic cervicalgia, occipital headaches, and unstable tandem gait.
J Neurointerv Surg
September 2025
Shanxi Key Laboratory of Brain Disease Control, Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China
Background: This study aims to develop an interpretable machine learning model using SHapley Additive exPlanations (SHAP) to predict favorable outcomes based on clinical, imaging, and angiographic data.
Methods: This study analyzed data from 184 patients with acute basilar artery occlusion (BAO) who underwent endovascular treatment (EVT) and completed a 90-day follow-up at Shanxi Provincial People's Hospital. A total of 68 medical variables were collected to develop predictive models using three machine learning algorithms: logistic regression (LR), support vector machine (SVM), and Light Gradient Boosting Machine (LightGBM).
Surg Radiol Anat
September 2025
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece.
Purpose: To describe and analyze two rare cases of arterial rings at the vertebrobasilar junction (VBJ), likely representing persistent segments of the primitive lateral basilovertebral anastomosis (PLBVA), and to explore their embryological origin and clinical significance.
Materials And Methods: Two morphological arterial variants were identified during a retrospective review of computed tomography angiography (CTA) scans from 505 patients. Multiplanar reconstruction and three-dimensional volume rendering were used for anatomical characterization.
Eur Arch Otorhinolaryngol
September 2025
Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, 75010, France.
Purpose: Cocaine-induced midline destructive lesions (CIMDL) represent a rare but severe consequence of intranasal cocaine abuse, occasionally progressing to skull base involvement with life-threatening complications. The aim of this manuscript is to describe an exceptional case of CIMDL with clival destruction and brainstem exposure, and to review current management strategies based on a systematic literature review.
Methods: We report a unique case of a 39-year-old woman with CIMDL extending to the clivus, resulting in encephalocele with basilar artery and brainstem exposure.