Vertebral basilar artery syndrome

General: 'Whiplash' injury with hyperextension of the 949e41j neck followed by rapid forward movement of the head or osteoarthritis of the cervical spine, cervical ribs (see Cranio-cervical Syndrome).

Ocular: Nystagmus (postural); internuclear ophthalmoplegia; visual deterioration; visual hallucinations may be associated with a decrease in consciousness; homonymous hemianopsia (bilateral); contralateral hemianopic visual field defect.

Clinical: Severe, throbbing occipital headache associated with neck pain; vertigo from ischemia of the internal auditory artery, from the temporoparietal cortex or from ischemia in the lateral tegmentum of the pons; nausea and vomiting; ataxia; hemiparesis; quadriplegia; dysarthria; dysphagia; deafness; dyslexia; atonia; confusion; coma; tremor.

Ca LR. Posterior cerebral artery syndrome. In: Vinken PJ, Bruyn GW; Klawans HL, eds. Handbook of Clinical neurology, vascular diseases, part I, vol. 53. Amsterdam: Elsevier Science, 1988.

Ca LR. 'Top of the basilar' syndrome. Neurology 1980; 30:72.

Hoyt WF. Transient bilateral blurring of vision: considerations of an episodic ischemic symptom of vertebral-basilar insufficiency. Arch Ophthalmol 1963; 70:746.

Millikan CH, Siekert RG. Studies in cerebrovascular disease: I. the syndrome of intermittent insufficiency of the basilar arterial system. Proc Mayo Clin 1965; 30:61.