In general, the prognosis of bilateral vertebral or basilar artery occlusions is very poor. No satisfactory management of this condition is known; in addition, the early diagnosis of severe lesions of the "intradural vertebrobasilar artery" on the basis of clinical signs and symptoms alone is difficult and regularly requires invasive procedures. Continuous-wave Doppler sonography has proved to be of great value in the primary diagnosis of vertebrobasilar thrombosis. In two cases, in whom bilateral intracranial vertebral artery lesions and basilar thrombosis were successfully treated with the help of local intraarterial fibrinolysis, Doppler sonography proved to be a reliable diagnostic tool for the evaluation and the non-invasive follow-up of thrombolysis. Clinical, Doppler sonographic and angiographic findings are presented and correlated.
