Vertebrobasilar thrombosis: Diagnosis, management, and the use of intra- arterial thrombolytics

Critical Care Medicine

Volumn 24, Issue 10, 1996, Pages 1729-1742

  Becker, Kyra J ^a,c   Purcell, Laura L ^a   Hacke, Werner ^b   Hanley, Daniel F ^a  

^a JOHNS HOPKINS HOSPITAL   (United States)

^b UNIVERSITY OF HEIDELBERG   (Germany)

^c NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE   (United States)

Author keywords

interventional angiography; neurologic emergencies; rehabilitation; stroke; thrombolytics; thrombosis

Indexed keywords

ALTEPLASE; ANTICOAGULANT AGENT; FIBRINOLYTIC AGENT; HEPARIN; HIRUDIN; LOW MOLECULAR WEIGHT HEPARIN; STREPTOKINASE; TISSUE PLASMINOGEN ACTIVATOR; UROKINASE;

ANGIOPLASTY; ANTICOAGULANT THERAPY; ARTICLE; BRAIN ANGIOGRAPHY; BRAIN CIRCULUS ARTERIOSUS; CLINICAL TRIAL; DRUG EFFICACY; EMERGENCY; FIBRINOLYTIC THERAPY; HUMAN; INTRAARTERIAL DRUG ADMINISTRATION; OCCLUSIVE CEREBROVASCULAR DISEASE; ORAL DRUG ADMINISTRATION; PRIORITY JOURNAL; RECANALIZATION; STROKE; TRANSIENT ISCHEMIC ATTACK; TREATMENT OUTCOME;

HUMANS; INTRACRANIAL EMBOLISM AND THROMBOSIS; THROMBOLYTIC THERAPY; VERTEBROBASILAR INSUFFICIENCY;

EID: 0029921944     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/00003246-199610000-00022     Document Type: Article

References (135)

1. Indredavik B, Bakke F, Solberg R, et al: Benefit of a stroke unit: A controlled randomized trial. Stroke 1991; 22:1026-1031
2. Lanhgorne P, Williams B, Gilchrist W, et al: Do Stroke units save lives? Lancet 1993; 342:395-398
3. Kalra L, Dale P, Crome P: Improving stroke rehabilitation: A controlled study. Stroke 1993; 24:1462-1467
4. Kubik S, Adams RA: Occlusion of the basilar artery - A clinical and pathological study. Brain 1946; 69:6-121
5. Haugsted Hans: Occlusion of the basilar artery: Diagnosis by vertebral angiography during life. Neurology 1956; 6:823-828
6. Archer CR, Horenstein S: Basilar artery occlusion: Clinical and radiographic correlation. Stroke 1977; 8:383-391
7. Brückmann H, Ferbert A, del Zoppo G, et al: Acute basilar thrombosis: Angiologic-clinical comparison and therapeutic implications. Acta Radiol 1987; 369(Suppl):38-42
8. Patterson JR, Grabois M: Locked-in syndrome: A review of 139 cases. Stroke 1986; 17:758-764
9. McDowell FH, Potes J, Groch S: The natural history of internal carotid and vertebral-basilar artery occlusion. Neurology 1961; 11:153-157
10. Bockenheimer St, Reinhuber F, Mohs C: Intraarterielle thrombolyse hirnversorgender Gefäße. Radiologe 1991; 31: 210-215
11. Thompson JR, Simmons CR, Hasso AN, et al: Occlusion of the intradural vertebrobasilar artery. Neuroradiology 1978; 4:219-229
12. Siekert RG, Millikan CH: Studies in cerebrovascular disease. II. Some clinical aspects of thrombosis of the basilar artery. Proceedings of the Staff Meetings of the Mayo Clinic 1955; 30:93-100
13. Castaigne P, Lhermitte F, Gautier JC, et al: Arterial occlusions in the vertebrobasilar system: A study of 44 patients with post-mortem data. Brain 1973; 96:133-154
14. Silversides JL: Basilar artery stenosis and thrombosis. Proceedings of the Royal Society of Medicine 1954; 47: 290-293
15. Fisher CM, Gore I, Okabe N, et al: Atherosclerosis of the carotid and vertebral arteries - extracranial and intracranial. J Neuropathol Exp Neurol 1965; 24:455-476
16. Cravioto H, Rey-Bellet J, Prose PH, et al: Occlusion of the basilar artery: A clinical and pathologic study of 14 autopsied cases. Neurology 1958; 8:145-152
17. Fields WS, Ratinov G, Wiebel J, et al: Survival following basilar artery occlusion. Arch Neurol 1966; 15:463-471
18. Hacke W, Zeumer H, Ferbert A, et al: Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 1988; 19:1216-1222
19. Bogousslavsky J, Gates PC, Fox AJ, et al: Bilateral occlusion of vertebral artery: Clinical patterns and long-term prognosis. Neurology 1986; 36:1309-1315
20. Nadeau S, Jordan J, Mishra S: Clinical presentation as a guide to early prognosis in vertebrobasilar stroke. Stroke 1992; 23:165-170
21. Moufarru NA, Little JR, Furlan AJ, et al: Basilar and distal vertebral artery stenosis: Long-term follow-up. Stroke 1986; 17:938-941
22. Cruz-Flores S, Gomez CR, Malkoff MD, et al: Isolated vertigo as the presentation of severe basilar artery occlusive disease. Ann Neurol 1994; 4(Suppl): A225
23. Ferbert A, Brückmann H, Drummen R: Clinical features of proven basilar artery occlusion. Stroke 1990; 21: 1135-1142
24. Miller Fisher C: The "herald hemiparesis" of basilar artery occlusion. Arch Neurol 1988; 45:1301-1303
25. Moscow NP, Newton TH: Angiographic implications in diagnosis and prognosis of basilar artery occlusion. Am J Radiol 1973; 119:597-604
26. Knepper L, Biller J, Adams Jr HP, et al: MR imaging of basilar artery occlusion. J Comput Assist Tomogr 1990; 14:32-35
27. Rother J, Wentz K, Rautenberg W, et al: Magnetic resonance angiography in vertebrobasilar ischemia. Stroke 1993; 24:1310-1315
28. Ringelstein EB, Zeumer H, Poeck K: Non-invasive diagnosis of intracranial lesions in the vertebrobasilar system. A comparison of doppler sonographic and angiographic findings. Stroke 1985; 16:848-854
29. Williams MA, Razumovsky AY, Diringer MN, et al: Transcranial doppler sonographic (TCD) monitoring of basilar artery thrombolysis. In: Thrombolytic Therapy in Acute Ischemic Stroke II. del Zoppo G, More E, Hacke W (Eds). New York, Springer Verlag, 1993, pp 298-300
30. Krieger D, Adams H, Rieke K, et al: Prospective evaluation of the prognostic significance of evoked potentials in acute basilar occlusion. Crit Care Med 1993; 21:1169-1174
31. Okada Y, Sadoshima S, Nakane H, et al: Early computed tomographic findings for thrombolytic therapy in patients with acute brain embolism. Stroke 1992; 23:20-23
32. del Zoppo GJ, Copeland BR, Walts TA, et al: The beneficial effect of intracarotid urokinase on acute stroke in a baboon model. Stroke 1986; 17:638-643
33. Benes V, Zabramski JM, Boston M, et al: Effect of intra-arterial antifibrinolytic agents on autologous arterial emboli in the cerebral circulation of rabbits. Stroke 1990; 21:1594-1599
34. Overgaard K, Sereghy T, Boysen G, et al: Reduction of infarct volume and mortality by thrombolysis in a rat embolic stroke model. Stroke 1992; 23:1167-1174
35. Bednar MM, Mcauliffe T, Raymond S, et al: Tissue plasminogen activator reduces brain injury in a rabbit model of thromboembolic stroke. Stroke 1990; 21:1705-1709
36. Mori E, Yoneda Y, Tabuchi M, et al: Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke. Neurology 1992; 42:976-983
37. Strandgaard S, Mackenzie ET, Sengupta D, et al: Upper limit of autoregulation of cerebral blood flow in the baboon. Circ Res 1974; 34: 435-440
38. Johansson B, Strandgaard S, Lassen NA: On the pathogenesis of hypertensive encephalopathy. Circ Res 1974; 34-35(Suppl 1):I167-I171
39. Boysen G, Engell HC, Pistolese GR, et al: On the critical lower level of cerebral blood flow in man with particular reference to carotid surgery. Circulation 1974; 49:1023-1025
40. Strandgaard S: Autoregulation of cerebral blood flow in hypertensive patients; the modifying influence of prolonged antihypertensive treatment on the tolerance to acute drug-induced hypotension. Circulation 1976; 53: 720-727
41. Strandgaard S, Olesen J, Skinhøj E, et al: Autoregulation of brain circulation in severe arterial hypertension. BMJ 1973; 1:507-510
42. Dirnagl U, Pulsinelli W: Autoregulation of cerebral blood flow in experimental focal brain ischemia. J Cereb Blood Flow Metab 1990; 10:327-336
43. Heiss WD, Rosner G: Functional recovery of cortical neurons as related to degree and duration of ischemia. Ann Neurol 1983; 14:294-301
44. Symon L, Pasztor E, Branston NJM: The distribution and density of reduced cerebral blood flow following acute middle cerebral artery occlusion: An experimental study by the technique of hydrogen clearance in baboons. Stroke 1974; 5:355-364
45. Meyer JS: Circulatory changes following occlusion of the middle cerebral artery and their relation to function. Neurosurgery 1958; 15:653-673
46. Waltz AJ: Effect of blood pressure on blood flow in ischemic and nonischemic cerebral cortex: The phenomena of autoregulation and luxury perfusion. Neurology 1968; 18:613-621
47. Astrup J, Siesjö B, Symon L: Thresholds in cerebral ischemia: The ischemic penumbra. Stroke 1981; 12:723-725
48. Fieschi C, Angnoli A, Battistini N, et al: Derangement of regional cerebral blood flow and of its regulatory mechanisms in acute cerebrovascular lesions. Neurology 1968; 18:1166-1179
49. Rem JA, Hachinski VC, Boughner DR, et al: Value of cardiac monitoring and echocardiography in TIA and stroke patients. Stroke 1985; 16:950-956
50. Myers MG, Norris JW, Hachinski VC, et al: Cardiac sequelae of acute stroke. Stroke 1982; 13:838-842
51. Norris JW, Hachinski VC, Myers MG, et al: Serum cardiac enzymes in stroke. Stroke 1979; 10:548-553
52. Lavy S, Yaar I, Melamed E, et al: The effect of acute stroke on cardiac functions as observed in an intensive stroke care unit. Stroke 1974; 5:775-780
53. Korpelainen JT, Sotaniemi KA, Suominen K, et al: Cardiovascular autonomic reflexes in brain infarction. Stroke 1994; 25:787-792
54. Sundt TM, Smith HC, Campbell JK, et al: Transluminal angioplasty for basilar artery stenosis. Mayo Clin Proc 1980; 55:673-680
55. Sugimori H, Ibayashi S, Fujii K, et al: Brain infarction developed in hypertensive and normotensive patients during hospitalization - Hemodynamic factors. Angiology 1995; 46:473-480
56. Nedergaard M: Transient focal ischemia in hyperglycemic rats is associated with increased cerebral infarction. Brain Res 1987; 408:79-85
57. Pulsinelli WA, Waldman S, Rawlinson D, et al: Moderate hyperglycemia augments ischemic brain damage: A neuropathological study in the rat. Neurology 1982; 32:1239-1246
58. 2+] after global cerebral ischemia in rats. J Neurol Sci 1995; 129:90-96
59. Warner DS, Gionet TX, Todd MM, et al: Insulin-induced normoglycemia improves outcome in hyperglycemic rats. Stroke 1992; 23:1775-1781
60. Vingerhoets F, Bogousslavsky J: Respiratory dysfunction in stroke. Clin Chest Med 1994; 15:729-737
61. Uchino H, Lundgren J, Smith M-L, et al: Preischemic hyperglycemia leads to delayed postischemic hyperthermia. Stroke 1994; 25:1825-1829
62. Ernst E, Hammershmidt DE, Bagge U, et al: Leukocytes and the risk of ischemic diseases. JAMA 1987; 257:2318-2324
63. Harrison MJG, Marshall J: Does the peripheral blood leukocyte count predict the risk of transient ischemic attacks and strokes? J Neurol Neurosurg Psychiatry 1987; 50:1558-1559
64. Young B, Ott L, Yingling B, et al: Nutrition and brain injury. J Neurotrauma 1992; 9:(Suppl)375-385
65. Young B, Ott L, Rapp R, et al: The patient with critical neurological disease. Crit Care Clin 1987; 3:217-233
66. Young B, Ott L, Phillips R, et al: Metabolic management of the patient with head injury. Neurosurg Clin North Am 1991; 2:301-320
67. Rouby J-J, Laurent P, Gosnach M, et al: Risk factors and clinical relevance of nosocomial maxillary sinusitis in the critically ill. Am J Respir Crit Care Med 1994; 150:776-783
68. Biller J, Bruno A, Adams Jr HP, et al: A randomized trial of aspirin or heparin in hospitalized patients with recent transient ischemic attacks; a pilot study. Stroke 1989; 20:441-447
69. Haley Jr EC, Kassell NF, Torner JC: Failure of heparin to prevent progression in progressing ischemic infarction. Stroke 1988; 19:10-14
70. Whisnant JP, Cartlidge NEF, Elveback LR: Carotid and vertebral-basilar transient ischemic attacks: Effect of anticoagulants, hypertension, and cardiac disorders on survival and stroke occurrence - a population study. Ann Neurol 1978; 3:107-115
71. Kay R, Wong KS, Yu YL, et al: Low-molecular-weight heparin for the treatment of acute ischemic stroke. New Engl J Med 1995; 333:1588-1593
72. Sussman BJ, Fitch TSP: Thrombolysis with fibrinolysin in cerebral arterial occlusion. JAMA 1958; 167:1705-1709
73. Fletcher AP, Alkjaersig N, Lewis M, et al: A pilot study of urokinase therapy in cerebral infarction. Stroke 1976; 7: 135-142
74. European Cooperative Study Group for Streptokinase Treatment in Acute Myocardial Infarction: Streptokinase in acute myocardial infarction. N Engl J Med 1979; 301:797-802
75. Wilcox RG, Olsson CG, Skene AM, et al: Trial of tissue plasminogen activator for mortality reduction in acute myocardial infarction: Anglo-Scandinavian study of early thrombolysis (ASSET). Lancet 1988; 2(8610):525-530
76. Gore JM, Sloan M, Price TR, et al: Intracerebral hemorrhage, cerebral infarction, and subdural hematoma after acute myocardial infarction and thrombolytic therapy in the thrombolysis in myocardial infarction study; thrombolysis in myocardial infarction, phase II, pilot and clinical trial. Circulation 1991; 83:448-459
77. O'Connor CM, Califf RM, Massey EW, et al: Stroke and myocardial infarction in the thrombolytic era: Clinical correlates and long-term prognosis. J Am Coll Cardiol 1990; 16:533-540
78. Second International Study of Infarct Survival Collaborative Group (ISIS-2): Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected myocardial infarction. Lancet 1988; 2(8607): 349-360
79. Third International Study of Infarct Survival Collaborative Group (ISIS-3): A randomised comparison of streptokinase vs. tissue plasminogen activator vs. anistreplase and of aspirin plus heparin vs aspirin alone among 41,299 cases of suspected acute myocardial infarction. Lancet 1992; 339:753-770
80. Maggioni AP, Franzosi MG, Santoro E, et al: The risk of stroke in patients with acute myocardial infarction after thrombolytic and antithrombotic treatment. N Engl J Med 1992; 327:1-6
81. Gruppo Italiano per lo Studio Della Sopravivenza nell'Infarto Miocardico: GISSI-2: A factorial randomised trial of alteplase versus streptokinase and heparin versus no heparin among 12,490 patients with acute myocardial infarction. Lancet 1990; 336:65-71
82. Antman EM for the TIMI 9A Investigators: Hirudin in acute myocardial infarction: Safety report from the thrombolysis and thrombin inhibition in myocardial infarction (TIMI) 9A trial. Circulation 1994; 90:1624-1630
83. The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIa Investigators: Randomized trial of intravenous heparin versus recombinant hirudin for acute coronary syndromes. Circulation 1994; 90:1631-1637
84. Neuhaus K-L, von Essen R, Tebbe U, et al: Safety observations from the pilot phase of the randomized r-hirudin for improvement of thrombolysis (HIT-III) study: A study of the arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärtze (ALKK). Circulation 1995; 90:1638-1642
85. Anderson JL, Karagoun WL, Allen A, et al: Older age and elevated blood pressure are risk factors for intracerebral hemorrhage after thrombolysis. Am J Cardiol 1991; 68:166-170
86. De Jaegere PP, Arnold AA, Balk AH, et al: Intracranial hemorrhage in association with thrombolytic therapy: Incidence and clinical predictive factors. J Am Coll Cardiol 1992; 19:289-294
87. Selker HP, Beshansky JR, Schmid CH, et al: Presenting pulse pressure predicts thrombolytic therapy-related intracranial hemorrhage: Thrombolytic predictive instrument (TPI) project results. Circulation 1994; 90:1657-1661
88. Mori E, Tabuchi M, Yoshida T, et al: Intracarotid urokinase with thromboembolic occlusion of the middle cerebral artery. Stroke 1988; 19:802-812
89. Wijdicks EFM, Jack Jr CR: Intracerebral hemorrhage after fibrinolytic therapy for acute myocardial infarction. Stroke 1993; 24:554-557
90. del Zoppo GJ, Poeck K, Pessin MS, et al: Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke. Ann Neurol 1992; 32: 78-86
91. del Zoppo GJ, Ferbert A, Otis SM, et al: Local intra-arterial fibrinolytic therapy in acute middle carotid territory stroke; a pilot study. Stroke 1988; 19:307-313
92. Haley Jr EC, Levy D, Brott TG, et al: Urgent therapy for stroke: Part II. A pilot study of tissue plasminogen activator administered 91-180 minutes from onset. Stroke 1992; 23:641-645
93. Zeumer H, Freitag H-J, Zanella F, et al: Local intra-arterial fibrinolytic therapy in patients with stroke: Urokinase versus recombinant tissue plasminogen activator (r-TPA). Neuroradiology 1993; 35:159-162
94. Overgaard K, Sperling B, Boysen G, et al: Thrombolytic therapy in ischemic stroke: A Danish pilot study. Stroke 1993; 24:1439-1446
95. von Kummer R, Hacke W: Safety and efficacy of intravenous tissue plasminogen activator and heparin in acute middle cerebral artery stroke. Stroke 1992; 23:646-652
96. Hacke W, Kaste M, Fieschi C, et al: Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA 1995; 274:1017-1025
97. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group: Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995; 333:1581-1587
98. Okada Y, Tamaguchi T, Minematsu K, et al: Hemorrhagic transformation in cerebral embolism. Stroke 1989; 20:598-603
99. Hornig CR, Dorndorf W, Agnoli AL: Hemorrhagic cerebral infarction: A prospective study. Stroke 1986; 17:179-185
100. Wolpert H, Greenlee R, Wechsler L, et al: Neuroradiologic evaluation of patients with acute stroke treated with recombinant tissue plasminogen activator. AJNR 1993; 14:3-13
101. Theron J, Courtheoux, Casasco A, et al: Local intra-arterial fibrinolysis in the carotid territory. AJNR 1989; 10: 753-765
102. Brandt T, Müller-Küppers M, von Kummer R, et al: Thrombolytic therapy for acute basilar occlusion: Predictors for recanalization and outcome. Submitted for publication
103. Huemer M, Niederwieser V, Ladurner G: Thrombolytic treatment for acute occlusion of the basilar artery. J Neurol Neurosurg Psychiatry 1995; 58:227-228
104. Nenci GG, Gresele P, Tamarelli M, et al: Thrombolytic therapy for thromboembolism of the vertebrobasilar artery. Angiology 1983; 34:561-571
105. Wildemann B, Hutschenreuter M, Krieger D, et al: Infusion of recombinant tissue plasminogen activator for treatment of basilar artery occlusion. Stroke 1990; 21:1513-1514
106. Herderschee D, Limburg M, Hijdra A, et al: Recombinant tissue plasminogen activator in two patients with basilar artery occlusion. J Neurol Neurosurg Psychiatry 1991; 54:71-73
107. Becker KJ, Monsein LH, Ulatowski J, et al: Intraarterial thrombolysis in vertebrobasilar occlusion. AJNR 1996; 17:1-8
108. Comerota AJ, Cohen GS: Thrombolytic therapy in peripheral arterial occlusive disease: Mechanisms of action and drugs available. Can J Surg 1993; 36:342-348
109. Ritchie JL, Hansen DD, Johnson C, et al: Combined mechanical and chemical thrombolysis in an experimental model: Evaluation by angiography and angioscopy. Am Heart J 1990; 119:64-72
110. Hsia J, Hamilton WP, Kleiman N, et al: A comparison between heparin and low-dose aspirin as adjunctive therapy with tissue plasminogen activator for acute myocardial infarction. N Engl J Med 1990; 323:1433-1437
111. Roux S, Christeller S, Ludin E: Effects of aspirin on coronary reocclusion and recurrent ischemia after thrombolysis: A meta-analysis. J Am Coll Cardiol 1992; 19:671-677
112. Bleich SD, Nichols TC, Schumacher RR, et al: Effect of heparin on coronary arterial patency after thrombolysis with tissue plasminogen activator in acute myocardial infarction. Am J Cardiol 1990; 66:1412-1417
113. Meijer A, Verheught FWA, Werter CJPJ, et al: Aspirin versus coumadin in the prevention of reocclusion and recurrent ischemia after successful thrombolysis: A prospective placebo-controlled angiographic study.Results of the APRICOT study. Circulation 1993; 87:1524-1530
114. Sundt TM, Smith HC, Piepgras DG, et al: Bypass and transluminal dilatation procedures for advanced occlusive disease of the posterior circulation. Neurosurg Rev 1982; 5:65-72
115. Gash AK, Spann JF, Sherry S, et al: Factors influencing reocclusion after coronary thrombolysis for acute myocardial infarction. Am J Cardiol 1986; 57:175-177
116. Higashida RT, Tsai FY, Halbach VV, et al: Transluminal angioplasty for atherosclerotic disease of the vertebral and basilar arteries. J Neurosurg 1993; 78:192-198
117. Spetzler RF, Hadley MN, Martin NA, et al: Vertebrobasilar insufficiency; Part 1: Microsurgical management of extracranial vertebrobasilar disease. J Neurosurg 1987; 66:648-661
118. Hopkins LN, Martin NA, Hadley MN, et al: Vertebrobasilar insufficiency; Part 2: Microsurgical treatment of intracranial vertebrobasilar disease. J Neurosurg 1987; 66:662-6674
119. Hopkins LN, Budny JL: Complications of intracranial bypass for vertebrobasilar insufficiency. J Neurosurg 1989; 70:207-211
120. Ausman JI, Diaz FG, de los Reyes RA, et al: Extracranial-intracranial anastomoses in the posterior circulation. In: Vertebrobasilar Arterial Occlusive Disease. Medical and Surgical Management. Berguer R, Bauer RB (Eds). New York, Raven Press, 1984, pp 313-319
121. Sundt TM Jr, Piepgras DG: Extracranial to intracranial bypass grafting: Posterior circulation. In: Neurosurgery. Wilkins RH, Rengachary SS (Eds). New York, McGraw Hill, 1985, pp 1281-1292
122. Fogelholm R, Aho K: Characteristics and survival of patients with brain stem infarctions. Stroke 1975; 6:328-333
123. Horner J, Buoyer FG, Alberts MJ, et al: Dysphagia following brain-stem stroke: Clinical correlates and outcome. Arch Neurol 1991; 48:1170-1173
124. Kahrilas PJ: Pharyngeal structure and function. Dysphagia 1993; 8:303-307
125. Shaker R: Functional relationship for the larynx and upper GI tract. Dysphagia 1993; 8:326-330
126. Sonies BC, Weiffenback J, Atkinson JC, et al: Clinical examination of motor and sensory functions of the adult oral cavity. Dysphagia 1987; 1:178-186
127. Perlman A, Langmore S, Milanti F, et al: Comprehensive clinical examination of oropharyngeal swallowing function: Veterans administration procedure. Seminars in Speech and Language 1991; 12:246-254
128. Sonies BC: Instrumental procedures for dysphagia diagnosis. Seminars in Speech and Language 1991; 12:185-198
129. Jones B, Donner MW: Examination of the patient with dysphagia. Radiology 1988; 167:319-326
130. Donner MW: Radiology in swallowing disorders. In: Radiology Today. Vol 2. Heuck FHW, Donner MW (Eds). Berlin, Springer-Verlag, 1981, pp 6-11
131. Bartolome G, Neumann S: Swallowing therapy in patients with neurologic disorders causing cricopharyngeal dysfunction. Dysphagia 1993; 8:146-149
132. Kahrilas PH, Logemann JL: Volume accommodation during swallowing. Dysphagia 1993; 8:259-265
133. Biglan AW, Burnstins RA, Roger GL, et al: Management of strabismus with botulinum A toxin. Ophthalmology 1989; 96:935-943
134. Osako M, Keltner JL: Botulinum A toxin (oculinum) in ophthalmology. Surv Ophthalmol 1991; 36:28-46
135. Balkan RJ, Poole T: A five year analysis of botulinum toxin type A injections: Some unusual features. Annals of Ophthalmology 1991; 23:326-333