Acute ischaemia of the vertebrobasilar circulation leads to a variety
of clinical manifestation and is mostly due to cardiogenic or artery-t
o-artery embolism. We describe four neurological emergency situations
involving vertebrobasilar artery aclusion of other origins: basilar mi
graine, extrinsic compression by rheumatoid inflammatory tissue, gener
alized vasculitis in subacute rheumatic fever and basilar artery disse
ction. The differential diagnosis of acute vertebrobasilar artery occl
usion may have an important impact on patient management.