Chen Szu-Ju, Tsai Li-Kai, Tang Sung-Chun, Jeng Jiann-Shing
Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
Acta Neurol Taiwan. 2017 Sep 15;26(3):138-143.
Isolated basilar artery dissection (BAD) is a rare cause of ischemic stroke. Since the clinical presentations and imaging findings could be non-specific and subtle, the diagnosis may be difficult. Here, we presented four cases of isolated BAD with acute ischemic stroke.
Four patients (age, 22 to 57 years) experienced acute onset of hemiparesis and/or vertigo with half of them having initial headache. Acute infarct was noted at pons or thalamus. Three cases needed more than one imaging modality or serial follow-up imaging to confirm a diagnosis of isolated BAD. Vascular tapering and/or false lumen restrictive to basilar artery were the commonest imaging findings. Three of our patients received anticoagulant without recurrent infarct or hemorrhagic complication. All of the patients had good functional outcome with modified Ranking scale scoring 1.
Isolated BAD may cause variable clinical manifestations and the outcome can be favorable. Application of different and advanced imaging studies with serial image follow-up are useful to confirm the diagnosis.
孤立性基底动脉夹层（BAD）是缺血性卒中的罕见病因。由于临床表现和影像学表现可能不具特异性且较为隐匿，诊断可能存在困难。在此，我们报告4例伴有急性缺血性卒中的孤立性BAD病例。
4例患者（年龄22至57岁）出现急性偏瘫和/或眩晕，其中半数患者首发症状为头痛。在脑桥或丘脑发现急性梗死灶。3例患者需要不止一种影像学检查方法或进行系列随访成像才能确诊为孤立性BAD。血管变细和/或基底动脉假腔受限是最常见的影像学表现。我们的3例患者接受了抗凝治疗，未出现再发梗死或出血并发症。所有患者功能预后良好，改良Rankin量表评分为1分。
孤立性BAD可能导致多种临床表现，且预后良好。应用不同的先进影像学检查并进行系列图像随访有助于确诊。
