Document Detail

Basilar artery vasculitis secondary to sphenoid sinusitis--case report.
MedLine Citation:
PMID:  11593974     Owner:  NLM     Status:  MEDLINE    
A 35-year-old male presented with basilar artery vasculitis secondary to sphenoid sinusitis manifesting as rapidly deteriorating symptoms including consciousness disturbance and right hemiparesis. Computed tomography (CT) on admission showed sphenoid sinusitis without intracranial lesion. Emergency angiography demonstrated basilar artery stenosis. The neurological deterioration was considered to be caused by ischemia of the perforating arteries branching from the stenotic portion of the basilar artery. The patient was treated with urokinase infusion through a microcatheter just proximal to the stenosis 3 hours after the onset of the symptoms. His consciousness level and right hemiparesis markedly improved immediately after the procedure. Magnetic resonance (MR) imaging on day 5 revealed that extension of the sphenoid sinusitis into the prepontine cistern had formed an abscess which was attached to the clivus. The basilar artery was embedded in the abscess at the angiographic stenosis. Cerebrospinal fluid (CSF) analysis showed white blood cell count of 601/mm3 with 82% neutrophils, 89.2 mg/dl protein, and 31 mg/dl glucose. No causative organism in the CSF could be identified by smear or culture. Early MR imaging and CSF examination are recommended when patients present with both ischemic symptoms involving the basilar artery and opacification of the sphenoid sinus on CT to identify basilar artery vasculitis secondary to sphenoid sinusitis.
T Sorimachi; K Kamada; T Ozawa; S Takeuchi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurologia medico-chirurgica     Volume:  41     ISSN:  0470-8105     ISO Abbreviation:  Neurol. Med. Chir. (Tokyo)     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-10-11     Completed Date:  2001-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0400775     Medline TA:  Neurol Med Chir (Tokyo)     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  454-7     Citation Subset:  IM    
Department of Neurosurgery, Nishiogi Central Hospital, Tokyo.
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MeSH Terms
Brain Abscess / diagnosis
Diagnosis, Differential
Neurologic Examination
Sphenoid Sinusitis / diagnosis*
Vasculitis, Central Nervous System / diagnosis*
Vertebrobasilar Insufficiency / diagnosis*

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