以“癫痫发作”为首发症状的基底动脉闭塞：三例机械取栓治疗病例
Basilar Artery Occlusion with "Seizures" as a Presenting Symptom: Three Cases Treated Using Mechanical Thrombectomy.
作者信息
Otsuji Ryosuke, Uno Junji, Motoie Ryota, Karashima Satoshi, Ren Nice, Nagaoka Shintaro, Maeda Kazushi, Ikai Yoshiaki, Gi Hidefuku
机构信息
Department of Neurosurgery, Baba Memorial Hospital, Sakai, Osaka, Japan.
Department of Neurosurgery, Baba Memorial Hospital, Sakai, Osaka, Japan.
出版信息
World Neurosurg. 2018 Sep;117:32-39. doi: 10.1016/j.wneu.2018.05.227. Epub 2018 Jun 7.
BACKGROUND
Basilar artery occlusion (BAO) is a rare, potentially fatal cause of ischemic stroke. It is often challenging to diagnose, especially when the presenting symptom is "seizures". We present 3 cases of patients with BAO presenting with seizures.
CASE DESCRIPTION
The first patient was a 53-year-old man with clonic convulsions. On angiography, BAO was detected and mechanical thrombectomy (MT) was performed. The modified Rankin Scale score at 3 months after treatment was 1. The second patient was a 64-year-old man with generalized convulsions. He was diagnosed with BAO and vertebral artery dissection and was treated with MT, percutaneous transluminal angioplasty, and stenting. The modified Rankin Scale score at 3 months after treatment was 3. The third patient was a 77-year-old man with tonic convulsions. He was diagnosed with BAO and treated with MT. However, he did not survive.
CONCLUSIONS
BAO is devastating; however, it is a treatable disease. Our report suggests that BAO should be suspected in patients presenting with initial convulsive seizures.
背景
基底动脉闭塞（BAO）是缺血性卒中的一种罕见且可能致命的病因。其诊断往往具有挑战性，尤其是当首发症状为“癫痫发作”时。我们报告3例以癫痫发作为表现的基底动脉闭塞患者。
病例描述
首例患者为一名53岁男性，出现阵挛性抽搐。血管造影检查发现基底动脉闭塞，并进行了机械取栓术（MT）。治疗后3个月时改良Rankin量表评分为1分。第二例患者为一名64岁男性，出现全身性惊厥。他被诊断为基底动脉闭塞和椎动脉夹层，并接受了机械取栓术、经皮腔内血管成形术和支架置入术治疗。治疗后3个月时改良Rankin量表评分为3分。第三例患者为一名77岁男性，出现强直性惊厥。他被诊断为基底动脉闭塞并接受了机械取栓术治疗。然而，他未能存活。
结论
基底动脉闭塞具有毁灭性；然而，它是一种可治疗的疾病。我们的报告提示，对于以初始惊厥性癫痫发作为表现的患者应怀疑基底动脉闭塞。
Zotero 插件