ABSTRACT
Objective To investigate the relation between microembolic signals (MES) and vertebral basilar artery ste?nosis in patients with brainstem infarction. Methods A total of 156 patients with acute brainstem infarction, who were de?termined the cerebral infarction lesion and vertebral basilar artery stenosis by cranial magnetic resonance imaging and CT an?giography, and were monitored by transcranial Doppler via occipital window of basilar arterial MES monitoring in 7 days of the onset, were divided into microembolus signal negative group (n=136) and positive group (n=20). The clinical data were compared between two groups. The differences of different degrees of stenosis were analyzed in two groups. The differences of different locations of stenosis in patients with vertebral basilar artery stenosis were analyzed in two groups. Logistic regres?sion analysis was used to analyse the factors affecting MES. Results There were no significant differences in age, gender, history of hypertension and diabetes mellitus between the two groups (P<0.05). There were significant differences in the dif?ferent degrees of stenosis between two groups, no or mild stenosis was found in MES-negative group and severe stenosis in MES-positive group (P<0.05). There were 70 cases with no vertebral basilar artery stenosis, 86 cases with mild, moderate and severe stenosis, in which 14 cases were MES-positive and 72 cases were negative. There were significant differences in different locations of stenosis between the two groups. The proportion of multiple infarctions was significantly higher in MES-positive group than that of MES-negative group (P<0.05). The intracranial vertebral basilar artery stenosis and 75%of ver?tebral basilar artery stenosis were the independent risk factors of MES-positive. Conclusion Severe stenosis of the verte?bral basilar artery is more vulnerable to occur MES of posterior circulation, leading to cerebral infarction. Microemboli may be the cause of multiple infarctions in patients with vertebral basilar artery stenosis.