Chapter 021. Syncope (Part 5)

Cerebrovascular Disease Cerebrovascular disease alone rarely causes syncope but may lower the threshold for syncope in patients with other causes. The vertebrobasilar arteries, which supply brainstem structures responsible for maintaining consciousness, are usually involved when cerebrovascular disease causes or contributes to syncope. An exception is the rare patient with tight bilateral carotid stenosis and recurrent syncope, often precipitated by standing or walking. Most patients who experience lightheadedness or syncope due to cerebrovascular disease also have symptoms of focal neurologic ischemia, such as arm or leg weakness, diplopia, ataxia, dysarthria, or sensory disturbances. Basilar artery migraine is a rare disorder that...