Amin-Hanjani S, et al. - In the prospective, observational VERiTAS study (Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack and Stroke) involving patients with recent vertebrobasilar transient ischemic attack or stroke and ≥50% atherosclerotic stenosis or occlusion in vertebral or basilar arteries, researchers examined whether hypoperfusion symptoms (defined as symptoms related to change in position, effort or exertion, or recent change in antihypertensive medication) correlated with quantitative measurements of flow compromise. The positive predictive value of hypoperfusion symptoms was 37.5% and the negative predictive value was 65.5% for low/borderline flow status. The symptoms of hypoperfusion were not related to the stroke result vs the flow status, which strongly predicted subsequent stroke risk. The study findings suggested that the symptoms of hypoperfusion alone correlate poorly with actual hemodynamic compromise as evaluated by quantitative magnetic resonance angiography and subsequent stroke risk in vertebrobasilar disease and are not a reliable flow measurement surrogate.