powerranger
Forum Junior
Topics: 10
Posts: 48
|
how does basilar artery occlusion manifest?
|
| achilles
Forum Guru
Topics: 90
Posts: 1,228
|
look for visual defects and signs of cerebellar dysfunction.
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
|
| guayoman
Forum Elite
Topics: 44
Posts: 273
|
It is very rare! Because the basilary artery is such a big vessel. When it does happen ...
[left]A 16-year-old-girl was admitted to the Neurology[/left] [left]services of All India Institute of Medical Sciences on[/left] [left]November 7, 1982 for evaluation of dysarthria and[/left] [left]ataxia. She had been entirely well until August 29,[/left] [left]1982 when she complained of a sudden sensation resembling[/left] [left]an electric current in the right lower limb,[/left] [left]lasting for half an hour. Next day she complained of a[/left] [left]similar sensation in the right half of the body, followed[/left] [left]by right hemiparesis. The weakness improved considerably[/left] [left]in the next 5 days. On September 22, 1982 she[/left] [left]had severe vertigo and repeated vomiting followed by[/left] [left]weakness of the left half of the face with increased[/left] [left]weakness of the right upper and lower limbs. Two days[/left] [left]later she became progressively dysarthric. Speech improved[/left] [left]after 6-7 days. During this period, she noticed[/left] [left]diminished taste sensation over the right half of the[/left] [left]tongue lasting for three days.[/left] [left]On October 12, 1982 she had sudden loss of consciousness[/left] [left]for two and a half hours. After this, her gait[/left] [left]was ataxic, speech was dysarthric and she started having[/left] [left]chorieform movements of all four limbs. Ataxia[/left] [left]and involuntary movements improved in the next five[/left] [left]days. On October 24, 1982 she had no involuntary[/left] [left]movements. About two weeks after this she was admitted[/left] [left]to this hospital because of persistence of the[/left] [left]dysarthria and ataxic gait.[/left] [left]After admission, while waiting for angiography, she[/left] [left]suddenly became stuporous with signs of peripheral[/left] [left]circulatory failure. Her blood pressure had fallen down[/left] [left]to 86/50 mm of Hg and pulse rate was 116 per minute.[/left] [left]She was given 5% i.v. dextrose saline (2 litres) and[/left] [left]injection dexamethasone, 4 mg i.v. stat and then repeated[/left] [left]every six hours for twenty four hours. She responded[/left] [left]to this treatment by the same evening. Blood[/left] [left]pressure went up to 110/70 and pulse rate came down[/left] [left]to 80 per minute. She was fully conscious and oriented.[/left] [left]Next day, a few hours after a transfemoral angiogram[/left] [left]she developed left hemiplegia. The weakness[/left] [left]started improving after 48 hours. Her speech, although[/left] [left]dysarthric could be understood and she could walk[/left] [left]with support.[/left]
___________________
Confidence does not come from simply reading the content, but from doing things with it. Confidence is born in the flash of insight, in the ability to face something new and figure it out.
Kaplan usmle edge newsletter
|
| guayoman
Forum Elite
Topics: 44
Posts: 273
|
[left]Comment[/left] [left]Occlusion of the basilar artery is a well known and[/left] [left]extensively documented entity in adults. Radiplogically[/left] [left]detectable occlusion of the basilar artery occurs one[/left] [left]fourth as often as occlusion of the carotid artery.1 Occlusive[/left] [left]disease of the basilar artery in children does[/left] [left]occur but is rare. Twenty cases have been reported in[/left] [left]childhood'"17 (table 1).[/left] [left]Ten patients were under the age of 10 years and the[/left] [left]remaining ten were under 16 years. The sex ratio is[/left] [left]approximately five males to one female. Only about[/left] [left]one third of children with basilar artery occlusion have[/left] [left]had proceeding transient ischemic attacks (TIA's) or[/left] [left]reversible ischemic neurological deficit (RIND) in the[/left] [left]territory of basilar artery.2 In childhood TIA's may be[/left] [left]less frequent than in adults, but the clinical symptoms[/left] [left]are similar.[/left] [left]The common presenting symptom in children is alteration[/left] [left]in sensorium. The classical symptoms i.e. altered[/left] [left]sensorium, hemiplegia or tetraplegia, and pupillary[/left] [left]abnormalities — have been seen in more than half[/left] [left]of the cases. The symptoms are usually bilateral and[/left] [left]there may be considerable improvement. The prognosis[/left] [left]is better in children as compared to adults.2 Basilar[/left] [left]artery occlusions in children have been attributed to[/left] [left]congenital causes, embolism, arteritis, the result of[/left] [left]trauma or have been of unknown cause (table 1). In the[/left] [left]present patient, no cause was identified.[/left] [left]Autopsy verification of the site of occlusion is available[/left] [left]in five cases.5-7> 14- " The mid-brain was the site of[/left] [left]lesion in three cases and the pons in two cases; the[/left] [left]thalamus and cerebellum were involved in one case[/left] [left]each. Vertebral angiography is necessary to make a[/left] [left]definite diagnosis. Four vessel angiography should be[/left] [left]done to rule out any developmental vascular anomalies,[/left] [left]laminar flow and spasm of the vertebral and basilar[/left] [left]basilar[/left] [left]arteries. Evidence of appropriate collateral circulation[/left] [left]is helpful in the diagnosis.2[/left] [left]Of all the previously reported cases, the three females[/left] [left]were under three years of age (table 1). Basilar[/left] [left]artery occlusion occuring in older children (up to 16[/left] [left]years of age) has not been reported previously in a[/left] [left]female.[/left]
___________________
Confidence does not come from simply reading the content, but from doing things with it. Confidence is born in the flash of insight, in the ability to face something new and figure it out.
Kaplan usmle edge newsletter
|
| guayoman
Forum Elite
Topics: 44
Posts: 273
|
I hate it when text comes out like that!
You can also read it from http://stroke.ahajournals.org/cgi/reprint/15/3/56...
___________________
Confidence does not come from simply reading the content, but from doing things with it. Confidence is born in the flash of insight, in the ability to face something new and figure it out.
Kaplan usmle edge newsletter
|
| powerranger
Forum Junior
Topics: 10
Posts: 48
|
thanks guys,
I think I got it....
thanks a lot..
|
|
| |
| | | | | | |
Similar forum topics