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I Have Been Diagnosed With Basilar Artery Occlusion With Collateral

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Posted on Mon, 29 Apr 2019
Question: I have been diagnosed with basilar artery occlusion with collateral blood flow. I've had 3 TIA in the last year. My Dr. Gave me meds clopedigrel, aspirin and a statin and that was it. Everything I read is not good. Can I last a while like this? Should I be driving? Should I get my affairs in order? I have headaches all the time. I was diagnosed last May.
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Follow up: Dr. Dariush Saghafi (0 minute later)
I have been diagnosed with basilar artery occlusion with collateral blood flow. I've had 3 TIA in the last year. My Dr. Gave me meds clopedigrel, aspirin and a statin and that was it. Everything I read is not good. Can I last a while like this? Should I be driving? Should I get my affairs in order? I have headaches all the time. I was diagnosed last May.
doctor
Answered by Dr. Dariush Saghafi (4 hours later)
Brief Answer:
Basilar Artery Occlusion--- Not as bad as you think in the 21st Century!

Detailed Answer:
Good morning from XXXXXXX OH and many thanks for writing to us for an opinion. I hope I can help you see a couple of things in a bit more context.

You're right about BASILAR ARTERY OCCLUSION not being a great thing to have. In fact, of all the intracranial arteries that one could choose to block....THAT ONE is far and way the most DARING one to mess with! Of course, you CHOSE to block that one, right? PLEASEEEE......Of course, it wasn't your choice....but it happened....so now let's talk about a few things to look be on guard for since we are 21st century human beings.....

1. You've got collateral circulation! Hey, there....you've got a Guardian XXXXXXX my friend.....You've got COLLATERAL CIRCULATION.....That MEANS that the occlusion to your basilar artery (the worst one to choose to block) has virtually THE BEST HELP and SUPPORT that the body could've possibly chosen....better than Plavix (Clopidogreal), better than statins, and I'm not exactly sure why the aspirin has to be there.....but if I had to take a guess....I'd say your doctor feels better by having prescribed that one for you....so be it.....Let the lad have a bit of fun.....

2. COLLATERAL Circulation....BEAUUUTIFULL....The basilar artery basically bloomed a DETOUR set of vascular connections OVER TIME....likely many years....so even though the main trunk is significantly blocked there is adequate rerouting taking blood AROUND the blockage....I'm telling you Roscoe.....you've got a GUARDIAN XXXXXXX on your shoulder. Now, is it good you had 3 TIA's? Heck no....we'd prefer it were zero....BUT.....you're beating the odds so far....people with this type of occlusive disease don't generally get away with 1 TIA let alone 3....sooooo again, someone's got big plans for you.....

3. How long can you last? Well, looks put it this way.....how long have you LASTED??? How long has it taken you to develop the blockage, put up a CONSTRUCTION PROJECT sign inside your head, reroute the blood, and continue to be a walking, talking, and living old SOB? I'll tell you....it's taken you years.....YEARS....this didn't happen over nbight....therefore, I believe you are going to simply see an expansion of that Interstate Project that will continue to remodel, reroute, and become even a stronger network of blood vessels to detour the BRIDGE THAT'S OUT...so to speak.

Look, you're not saying much about your CONTROLLABLE risk factors...but honestly, if you really get your LIFESTYLE straightened out to the maximum and optimum level possible, stop smoking, stop drinking, EXERCISING, LOSING WEIGHT (if applicable)...then, I'm not sure you necessarily have to stop driving or even "get your affairs in order" in the sense that it's gonna' be ADIOS, BON VOYAGE, NICE KNOWIN' 'YA kid....Look, it's always a GREAT idea to have your affairs in order, isn't it? Just like it's always nice for everyone in NYC to have an escape plan in case you suddenly have to get out, right? Do you? Have you practiced it? Do you keep revising it every year depending on the improved military powers of all terrorist groups in the world, etc.? HAHAHA! Same difference......Is it necessary to get your "affairs" in order? Well, yeah....EVERYONE SHOULD have their affairs in order even if they are YOUNG KIDS...right? It's not JUST for people that have major medical issues or who are terminal. EVERYONE should be ready for anything, at any time, anywhere.

But that doesn't mean you should be walking on eggshells wondering or not if TODAY is the day.....because EVERYONE can live like that.....you just don't know what's up man.....but you can control your personal risk factors, right? You can control weight, physical conditioning, smoking and drinking habits, food choices, exercise vigorously at least 2-3x/week, cope with stress/anxiety/fear, etc. and not drive yourself nuts trying to control or alter things that you cannot control.

So everyone talks about doom and gloom but check this article out...just look at the TITLE please and then, tell me whether or not it's worth looking at the glass half empty or half full????

July 30, 2013
Good Outcomes Are Possible for Basilar Artery Occlusion

Hooman Kamel, MD reviewing Strbian D et al. XXXXXXX Neurol 2013 Jul 8

Many patients without extensive ischemia on baseline imaging can recover well with aggressive modern stroke care.


And here is Dr. Kamel's Editorial comment on this article:

Based on this study, two things are clear: First, the degree of baseline ischemia strongly predicts outcomes after basilar artery occlusion and thus can help with treatment decisions; second, in the absence of extensive baseline ischemia, modern stroke care for basilar artery occlusion can lead to good outcomes.

It might be a good thing to pull back on driving since that's an activity that could involve hurting others or damaging property in the event you were to have another TIA, right? Maybe you can strike a "frequent flyer's Program" with UBER or something....or could you take up cycling? Have you gotten MRI's done after those TIA's and if so, what was the baseline D/PWI studies showing.....

Just keep your perfusion pressures up but drinking lots of water, staying very well hydrated, start really hitting the gym, get on a diet of veggies and fruits, cut out everything dietary that you know is junk and can only gunk up your arteries. Go to salads, soups, and lots of protein, cut out the sugars.....

As a headache specialist I can tell you that the headaches can be a little challenging to treat but they can be addressed by someone in the know. I invite you to CLEVELAND! LOL.....well, not as crazy an idea as you might think.....just had a gentleman from this network visit me today from XXXXXXX CT....he had a heckuva time making his plane this morning (he actually missed it because of an accident during rush hour that bottlenecked everything....but he caught the next flight out and we had a very enjoyable session together in the late afternoon taking care of his problem.

Headaches can be challenging in these types of situations but they are definitely treatable and manageable without putting you at risk for complications or excessively lowering blood pressures.

If I've provided useful or helpful information to your questions could you do me the utmost of favors in CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information if you'd care to drop me a line at www.bit.ly/drdariushsaghafi

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this discussion has aided in your understanding of a few concepts related to your problems and if you did want to contemplate a quick jog into XXXXXXX where them INDIANS are looking to win a Division Title this year...then, by all means give us a ring at 440.842.3816 and we can give you details of how best to come over for an extensive and thorough examination and leave with expert advice on what you can do to support the title of this response "Basilar Artery Occlusion---Not as bad as you think in the 21st Century!"

This query required 54 minutes of professional time to research, assimilate, and file a response.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dariush Saghafi (0 minute later)
Brief Answer:
Basilar Artery Occlusion--- Not as bad as you think in the 21st Century!

Detailed Answer:
Good morning from XXXXXXX OH and many thanks for writing to us for an opinion. I hope I can help you see a couple of things in a bit more context.

You're right about BASILAR ARTERY OCCLUSION not being a great thing to have. In fact, of all the intracranial arteries that one could choose to block....THAT ONE is far and way the most DARING one to mess with! Of course, you CHOSE to block that one, right? PLEASEEEE......Of course, it wasn't your choice....but it happened....so now let's talk about a few things to look be on guard for since we are 21st century human beings.....

1. You've got collateral circulation! Hey, there....you've got a Guardian XXXXXXX my friend.....You've got COLLATERAL CIRCULATION.....That MEANS that the occlusion to your basilar artery (the worst one to choose to block) has virtually THE BEST HELP and SUPPORT that the body could've possibly chosen....better than Plavix (Clopidogreal), better than statins, and I'm not exactly sure why the aspirin has to be there.....but if I had to take a guess....I'd say your doctor feels better by having prescribed that one for you....so be it.....Let the lad have a bit of fun.....

2. COLLATERAL Circulation....BEAUUUTIFULL....The basilar artery basically bloomed a DETOUR set of vascular connections OVER TIME....likely many years....so even though the main trunk is significantly blocked there is adequate rerouting taking blood AROUND the blockage....I'm telling you Roscoe.....you've got a GUARDIAN XXXXXXX on your shoulder. Now, is it good you had 3 TIA's? Heck no....we'd prefer it were zero....BUT.....you're beating the odds so far....people with this type of occlusive disease don't generally get away with 1 TIA let alone 3....sooooo again, someone's got big plans for you.....

3. How long can you last? Well, looks put it this way.....how long have you LASTED??? How long has it taken you to develop the blockage, put up a CONSTRUCTION PROJECT sign inside your head, reroute the blood, and continue to be a walking, talking, and living old SOB? I'll tell you....it's taken you years.....YEARS....this didn't happen over nbight....therefore, I believe you are going to simply see an expansion of that Interstate Project that will continue to remodel, reroute, and become even a stronger network of blood vessels to detour the BRIDGE THAT'S OUT...so to speak.

Look, you're not saying much about your CONTROLLABLE risk factors...but honestly, if you really get your LIFESTYLE straightened out to the maximum and optimum level possible, stop smoking, stop drinking, EXERCISING, LOSING WEIGHT (if applicable)...then, I'm not sure you necessarily have to stop driving or even "get your affairs in order" in the sense that it's gonna' be ADIOS, BON VOYAGE, NICE KNOWIN' 'YA kid....Look, it's always a GREAT idea to have your affairs in order, isn't it? Just like it's always nice for everyone in NYC to have an escape plan in case you suddenly have to get out, right? Do you? Have you practiced it? Do you keep revising it every year depending on the improved military powers of all terrorist groups in the world, etc.? HAHAHA! Same difference......Is it necessary to get your "affairs" in order? Well, yeah....EVERYONE SHOULD have their affairs in order even if they are YOUNG KIDS...right? It's not JUST for people that have major medical issues or who are terminal. EVERYONE should be ready for anything, at any time, anywhere.

But that doesn't mean you should be walking on eggshells wondering or not if TODAY is the day.....because EVERYONE can live like that.....you just don't know what's up man.....but you can control your personal risk factors, right? You can control weight, physical conditioning, smoking and drinking habits, food choices, exercise vigorously at least 2-3x/week, cope with stress/anxiety/fear, etc. and not drive yourself nuts trying to control or alter things that you cannot control.

So everyone talks about doom and gloom but check this article out...just look at the TITLE please and then, tell me whether or not it's worth looking at the glass half empty or half full????

July 30, 2013
Good Outcomes Are Possible for Basilar Artery Occlusion

Hooman Kamel, MD reviewing Strbian D et al. XXXXXXX Neurol 2013 Jul 8

Many patients without extensive ischemia on baseline imaging can recover well with aggressive modern stroke care.


And here is Dr. Kamel's Editorial comment on this article:

Based on this study, two things are clear: First, the degree of baseline ischemia strongly predicts outcomes after basilar artery occlusion and thus can help with treatment decisions; second, in the absence of extensive baseline ischemia, modern stroke care for basilar artery occlusion can lead to good outcomes.

It might be a good thing to pull back on driving since that's an activity that could involve hurting others or damaging property in the event you were to have another TIA, right? Maybe you can strike a "frequent flyer's Program" with UBER or something....or could you take up cycling? Have you gotten MRI's done after those TIA's and if so, what was the baseline D/PWI studies showing.....

Just keep your perfusion pressures up but drinking lots of water, staying very well hydrated, start really hitting the gym, get on a diet of veggies and fruits, cut out everything dietary that you know is junk and can only gunk up your arteries. Go to salads, soups, and lots of protein, cut out the sugars.....

As a headache specialist I can tell you that the headaches can be a little challenging to treat but they can be addressed by someone in the know. I invite you to CLEVELAND! LOL.....well, not as crazy an idea as you might think.....just had a gentleman from this network visit me today from XXXXXXX CT....he had a heckuva time making his plane this morning (he actually missed it because of an accident during rush hour that bottlenecked everything....but he caught the next flight out and we had a very enjoyable session together in the late afternoon taking care of his problem.

Headaches can be challenging in these types of situations but they are definitely treatable and manageable without putting you at risk for complications or excessively lowering blood pressures.

If I've provided useful or helpful information to your questions could you do me the utmost of favors in CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information if you'd care to drop me a line at www.bit.ly/drdariushsaghafi

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this discussion has aided in your understanding of a few concepts related to your problems and if you did want to contemplate a quick jog into XXXXXXX where them INDIANS are looking to win a Division Title this year...then, by all means give us a ring at 440.842.3816 and we can give you details of how best to come over for an extensive and thorough examination and leave with expert advice on what you can do to support the title of this response "Basilar Artery Occlusion---Not as bad as you think in the 21st Century!"

This query required 54 minutes of professional time to research, assimilate, and file a response.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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I Have Been Diagnosed With Basilar Artery Occlusion With Collateral

I have been diagnosed with basilar artery occlusion with collateral blood flow. I've had 3 TIA in the last year. My Dr. Gave me meds clopedigrel, aspirin and a statin and that was it. Everything I read is not good. Can I last a while like this? Should I be driving? Should I get my affairs in order? I have headaches all the time. I was diagnosed last May.