A 33 year-old man arrived after 3h with dysarthria and right-sided hemiparesis (National
Institutes Health Stroke Scale (NIHSS:11)). We perform IV thrombolysis and after 1h, NIHSS: 4.
After 24h, he presented fluctuating neurological symptoms. Angiography and CT-angio (CTA)
(Figures A and B) demonstrated an isolated dissection of the basilar artery, without subarachnoid
hemorrhage. Anticoagulation was initiated with rapid improvement. After 7 days he was
discharged with NIHSS: 2, Rankin: 2. CTA (Figure C)
showed partial basilar recanalization, and after 6 months (Figure D) the basilar artery was normal. Although not considered a formal
therapeutic option for arterial dissection 11 . Caplan LR: Dissection of brain-supplying arteries. Nat Clin Pract Neurol
2008;4:34-42.
2 . Kim BM, Suh SH, Park SI, et al. Management and clinical outcome of acute
basilar artery dissection. Am J Neuroradiol 2008;29:1937-1941.
-
33 . Tognola WA, Centola Filho CA, Chueire RHFM. Dissecção da artéria basilar:
relato de caso. Arq Neuropsiquiatr 2000;58:356-359 , IV thrombolysis was performed and maybe prevented microembolic events, improving
prognosis 44 . Droste DW, Junker K, Stogbauer F, et al. Clinically silent circulating
microemboli in 20 patients with carotid and vertebral artery dissection. Cerebrovasc Dis
2001;12:181-185.
,
55 . Ruecker M, Furtner M, Knoflach M, et al. Basilar artery dissection: series
of 12 consecutive cases and review of the literature: Cerebrovasc Dis
2010;30:267-276. .
A) Basilar artery dissection without vertebral artery involvement in Digital Subtraction Angiography – lateral image (arrow). B) CT-angio: Isolated narrowing of basilar artery in day 1 (arrowhead). C) Partial recanalization of basilar artery lumen in day 7 (arrowhead). D) After six months, basilar artery without pseudoaneurysm and improvement of recanalization (arrowhead).
References
-
1Caplan LR: Dissection of brain-supplying arteries. Nat Clin Pract Neurol 2008;4:34-42.
-
2Kim BM, Suh SH, Park SI, et al. Management and clinical outcome of acute basilar artery dissection. Am J Neuroradiol 2008;29:1937-1941.
-
3Tognola WA, Centola Filho CA, Chueire RHFM. Dissecção da artéria basilar: relato de caso. Arq Neuropsiquiatr 2000;58:356-359
-
4Droste DW, Junker K, Stogbauer F, et al. Clinically silent circulating microemboli in 20 patients with carotid and vertebral artery dissection. Cerebrovasc Dis 2001;12:181-185.
-
5Ruecker M, Furtner M, Knoflach M, et al. Basilar artery dissection: series of 12 consecutive cases and review of the literature: Cerebrovasc Dis 2010;30:267-276.
Publication Dates
-
Publication in this collection
Jan 2014
History
-
Received
20 May 2013 -
Reviewed
22 July 2013 -
Accepted
29 July 2013