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A case is reported of a 72-year-old woman who presented with severe vertigo, vomit, and mild neck and occipital pain. She had a medical history of hypertension, angina pectoris, cholelithiasis, gastric ulcer, pyelonephritis and periodical mild dizziness. Neuroimaging revealed right vertebral artery occlusion, right cerebellar stroke and basilar impression. The therapeutic approach chosen in our patient was conservative, with non-steroid anti-inflammatory drugs and neck collar. Although our patient's prior risk factors for stroke supported a diagnosis of vertebrobasilar stroke, it is possible that the vertebral artery occlusion was the result of changes in the atlantoaxial anatomy and that cerebellar infarction was secondary to craniocervical anomaly. Although the presence of vertebral artery occlusion, cerebellar stroke and basilar impression in our patient may have been coincidental, we suggest that patients with basilar impression and craniocervical anomalies in general may be at an increased risk of vertebrobasilar vascular disease and vertebrobasilar stroke.

Vertebrobasilar acclusion is a life-treatening event that requeres prompt diagnostic evaluation and subsequent therapy. Advanced magnetic resonance imagin (MRI) methods, including diffusion-weighted imaging and magnetic resonance angiography (MRA), are highly sensitive for the detection of ischemic tissue injury, and for the detection and localization of intracranial arterial occlusion and stenosis.In the era of thrombolytic therapy , MRI and MRA provide useful information for therapeutic decision making in the early stage of stroke evaluation. This retrospective review included patients with posterior circulation symptomatology examined at our Department between July 2002 and January 2005, 8 female and 11 male, mean age 54, 9 years.The aim was to present the possibilities of mRI and MRA in the management of patients with iscemic stroke in posterior circulation.

iznose se podaci retrospektivne analize 15 reprezentativnih slučajeva bolesnika sa kliničkom slikom stražnje cirkulacije.Pomoću MRA je otkrila u 46, 6 % slučaja okluziju bazilarne arterije, 6, 6 % stenozu bazilarne arterije, u 13 % slučaja aterosklertoske promjene vertebrobazilarnog sliva, u 13 % okluziju vertebralne arterije.

The aim was to compare US, CT and MR findings of cerebtovascular disease, particularly of its entities. The data on 20 patients (MIF 13/7) with the clinical history of transitory ischaemic attacks (TIA) or stroke were evaluated. Ten patients had TIA and ten CV stroke. The personal history was taken, clinical examinations and laboratory tests done, and followed by carotid and vertebral Colour Doppler Brain CT was done 24 to 48 hours afler the clinical manifestation of TIA or stroke. MR (1.0 T) was done 3 to 9 days afier the beginning of the disease. Colour Doppler showed subtotal intemal carotid artery stenosis in 14 patients, and vertebral artery occlusion in 6 patients. CT findings did not show isehaemic infarction lesions in 9 patients. Six patients had ischaemic infarction lesions and 5 patients had multiple white matter isehaemic lesions. MR showed ischaemic lesions in all patients: ishemic infarct lesions in l2 patients, white matter changes in 5, and lacune in 5 patients. Two patients had both ischaemic lesions and lacune. In several cases MR-angiography was done. CONCLUSION: Advantages of MRI over CT in t.he diagnosing cerebrovascular disease are in the fact that edematous changes in the region of the recent infarction can be detected much earlier on MR images. MR provides a better insight into the zones of petechial bleeding of infarction region in a subacute stage.