In patients with suspected cerebrovascular disease, simultaneous bilateral ocular symptoms typically originate from which arteries?

In cases of cerebrovascular disease, simultaneous bilateral ocular symptoms are most commonly associated with issues arising from the vertebrobasilar arteries. This is due to the unique vascular supply that the vertebrobasilar system provides to the brainstem and posterior circulation, which includes critical areas that control eye movement and vision.

When there is compromised blood flow or ischemia in the vertebrobasilar arteries, it can lead to bilateral symptoms affecting ocular function, as these arteries supply the areas of the brain responsible for coordinating eye movements and processing visual information. This is particularly relevant in conditions like vertebrobasilar insufficiency or basilar artery occlusion, where the blood supply to these regions is diminished.

In contrast, the internal carotid and common carotid arteries primarily supply the anterior circulation of the brain, affecting regions responsible for anterior visual field processing and unilateral symptoms. The subclavian arteries primarily supply the arms and do not directly impact ocular symptoms. Therefore, when considering the bilaterality of ocular symptoms in cerebrovascular conditions, the vertebrobasilar arteries are the primary vessels involved.