Case Report: Stroke Chameleon: Acute Large Vessel Occlusion in the Posterior Circulation With Paroxysmal Sympathetic Hyperactivity as the First Manifestation

Autor: Juntao Yin, Wan Wang, Yu Wang, Guofeng Li, Yongmei Kong, Xiaoqiang Li, Yingdong Xu, Yuqing Wei
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Frontiers in Neuroscience, Vol 16 (2022)
Druh dokumentu: article
ISSN: 1662-453X
DOI: 10.3389/fnins.2022.890678
Popis: Paroxysmal sympathetic hyperactivity (PSH) is a neurological emergency mostly secondary to traumatic brain injury (TBI). Acute large vessel occlusion (LVO) in the posterior circulation with PSH as the initial manifestation is uncommon. It may lead to catastrophic consequences for patients if not detected and treated timely. Here, we present three patients with acute LVO in the posterior circulation with PSH as the initial symptom. All patients were male and averaged 63 years old. The PSH Assessment Measure (PSH-AM) scores of all cases were > 17. Brain imaging showed that multiple lesions in posterior circulation were involved in three patients. Although the prognosis of all patients was poor, PSH symptoms disappeared in all patients after endovascular treatment. These cases suggests that acute posterior circulation-related ischemic stroke should be considered with PSH occurring as the first symptom. Extensive disconnection due to multiple lesions in posterior circulation may play an important role in the occurrence and development of PSH. Endovascular treatment may be effective for PSH caused by acute posterior circulation-related ischemic stroke. This is worthy of further study in the future.
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