| Heralding manifestations of basilar artery occlusion with lethal or severe stroke. | |
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MedLine Citation:
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PMID: 14638878 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Basilar artery occlusion usually causes severe disability or death. Until the recent developments in local intra-arterial or systemic intravenous fibrinolysis, interest in early diagnosis was low because there was no satisfactory treatment. Thus there is little information about the initial phase of the disease. OBJECTIVE: To report on the early clinical features and patterns of evolution of severe symptomatic basilar artery occlusion. METHODS: 24 patients with established basilar artery occlusion (confirmed by angiography or at necropsy) were reviewed retrospectively, focusing on the early clinical aspects and time course of the disease. RESULTS: The most common initial symptoms were motor deficits (16/24, including facial palsies), articulatory speech difficulties (15/24), vertigo, nausea or vomiting (13/24), and headaches (10/24). The most frequent objective initial findings were motor deficits (22/24), facial palsies (19/24), eye movement abnormalities (15/24), lower cranial nerve deficits (15/24), altered level of consciousness (12/24), and bilateral extensor plantar responses (9/24). Onset of the disease was gradual in nearly all patients and in half the warning signs were present for up to two months before the final stage. Headaches and visual disturbances were early signs, while speech difficulties and motor deficits were late signs. Once permanent neurological deficits were present, the final illness was reached within six hours in 41%, between six and 24 hours in 32%, and in two to three days in 27%. CONCLUSIONS: All the patients reviewed presented some symptoms and signs pointing to brain stem involvement. Only 8% (2/24) had an acute course with no adequate warning signs. |
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Authors:
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G von Campe; F Regli; J Bogousslavsky |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurology, neurosurgery, and psychiatry Volume: 74 ISSN: 0022-3050 ISO Abbreviation: J. Neurol. Neurosurg. Psychiatr. Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2003-11-25 Completed Date: 2004-01-13 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 2985191R Medline TA: J Neurol Neurosurg Psychiatry Country: England |
Other Details:
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Languages: eng Pagination: 1621-6 Citation Subset: IM |
Affiliation:
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Department of Neurology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Arterial Occlusive Diseases / complications, diagnosis*, physiopathology* Basilar Artery / physiopathology*, radiography Cerebral Angiography Female Humans Magnetic Resonance Angiography Male Middle Aged Retrospective Studies Severity of Illness Index Stroke / etiology*, mortality, physiopathology* Time Factors |
| Comments/Corrections | |
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