Treatment Strategies for Basilar Top Syndrome Caused by Acute Vertebral Artery Occlusion.

Autor: Kojima I; Department of Neuroendovascular Treatment, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan., Shimozato R; Department of Neuroendovascular Treatment, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan., Hayashi M; Department of Neuroendovascular Treatment, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan., Iijima A; Department of Neuroendovascular Treatment, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Journal of neuroendovascular therapy [J Neuroendovasc Ther] 2020; Vol. 14 (6), pp. 215-221. Date of Electronic Publication: 2020 Mar 31.
DOI: 10.5797/jnet.cr.2019-0024
Abstrakt: Objective: We report a patient with basilar artery embolism caused by vertebral artery stenosis who was successfully treated using simultaneous percutaneous transluminal angioplasty (PTA) and mechanical thrombectomy.
Case Presentation: A 64-year-old male, who had undergone medical treatment for cerebellum infarction at another hospital, was referred to our hospital due to disturbance of consciousness. Angiography revealed acute occlusion of the first part of the right vertebral artery and an embolism of the top of basilar artery. After performing PTA to create an approach route for the embolism, we collected it using a clot recovering device. The postoperative course was good, and the patient was discharged with mild ataxia and dysarthria.
Conclusion: We report the successful treatment of progressive cerebral infarction of the posterior circulation with revascularization 30 hours after symptom onset. Unlike the anterior circulation, the posterior circulation consists of smaller arteries and fewer collateral arteries, making it vulnerable to ischemic attack. Therefore, shortening the time until treatment may improve the outcome.
Competing Interests: We declare no conflict of interest regarding this article.
(©2020 The Japanese Society for Neuroendovascular Therapy.)
Databáze: MEDLINE
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