Case reports reveal contrasting patient outcomes from endovascular treatment in vertebral artery occlusion, suggesting timely intervention for anterior spinal artery compromise is critical.
Vertebral artery (VA) occlusion is often managed conservatively, but anterior spinal artery (ASA) involvement may cause rapid neurological deterioration. We report two contrasting cases of VA occlusion with ASA compromise. One patient achieved complete recovery after timely endovascular treatment (EVT) restoring ASA flow, whereas the other developed severe bilateral medial medullary infarctions following unsuccessful EVT. These cases highlight the prognostic importance of ASA involvement and suggest that EVT should be considered when ASA perfusion is threatened.
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Lee et al. (2026) studied this question.
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