Vertebrobasilar Disease

About 20 percent of ischemic strokes involve the posterior circulation. The correct diagnosis is often delayed, and workups in patients with symptoms may not always suggest vertebrobasilar disease. This review explains the causes, typical presentations, and characteristic findings of common strokes resulting from disease in the vertebral, basilar, or posterior cerebral arteries. Recommendations are made for treatment with thrombolytic agents and the prophylactic use of antiplatelet agents or anticoagulants.