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Arquivos de Neuro-Psiquiatria

versión impresa ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.55 no.3B São Paulo set. 1997

http://dx.doi.org/10.1590/S0004-282X1997000400007 

Ectasia da artéria basilar e acidente vascular cerebral: aspectos clínicos de 21 casos

 

Basilar ectasia and stroke: clinical aspects of 21 cases

 

 

Roberto de Magalhães Carneiro de OliveiraI; José Osmar CardealII; José Geraldo de Camargo LimaIII

IDisciplina de Neurologia da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina: Pós graduando
IIDisciplina de Neurologia da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina: Professor Adjunto

IIIDisciplina de Neurologia da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina: Professor Titular (aposentado)

 

 


RESUMO

A ectasia da artéria basilar (EB) é a dilatação do calibre em toda ou parte de sua extensão, e/ou quando for anormalmente tortuosa em seu trajeto. As manifestações clínicas são decorrentes de compressão de nervos cranianos, fenômeno isquêmico ou hemorrágico, síndrome de pseudo-tumor ou hidrocefalia. Procuramos descrever casos da associação de EB e acidente vascular cerebral (AVC), analisar sua frequência, aspectos clínicos e os mecanismos envolvidos nas diferentes formas de apresentação clínica desta entidade. Encontramos 21 pacientes com AVC e EB. A associação de EB e AVC foi prevalente em indivíduos do sexo masculino após 50 anos. Os principais sintomas observados foram hemiparesia, alteração de nervos cranianos e ataxia cerebelar. Na instalação do AVC foram importantes as tonturas rotatórias e a cefaléia. Os infartos relacionados à EB puderam ser atribuídos a diferentes mecanismos: trombose da artéria, embolia artério-arterial, efeito de massa com angulação e obstrução de ramos das artérias vertebrais e basilar.

Palavras-chave: acidente vascular cerebral, ectasia, insuficiência vértebro-basilar.


ABSTRACT

Ectasia of the basilar artery (EB) occurs when its diameter is greater than normal along all or part of its course, and/or when it is abnormally tortuous. EB may cause cranial nerve dysfunction, ischemic stroke or subarachnoid hemorrhage, pseudotumor or hydrocephalus. We tried to describe cases of stroke associated with EB, analyze its frequency, clinical aspects, and the mechanisms involved in different forms of its presentation. We found 21 patients with stroke and EB. The association between EB and stroke was more prevalent in males over the age of fifty. Main symptoms were hemiparesia, cranial nerves dysfunction, and cerebellar ataxia. Cerebral infarcts associated with EB were due to different mechanisms: arterial thrombosis, artery-to-artery embolism, mass effect with angulation and obstruction of the vertebral and basilar branches.

Key-words: cerebrovascular disorder, vertebrobasilar insufficiency, ectasia.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

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Aceite: 5-maio-1997.

 

 

Dr. Roberto de Magalhães Carneiro de Oliveira - Disciplina de Neurologia, Escola Paulista de Medicina - Rua Botucatu 762 - 04023-900 São Paulo SP - Brasil.