Dakaj Nazim, Gocaj Kaltrina, Kabashi Serbeze, Dedushi Kreshnike, Blakaj Vullnet, Goçaj Alba
Assistant Professor at Alma Mater Europea" Rezonanca", Specialist of Neurology, KSHM, Rezonanca, Veterrnik 10000, Prishtine, Kosove.
Radiology Resident in University Clincial Center of Kosova, Rrahim Beqiri, Pika Exclusive Llam B-41, Prishtine, Kosove.
Radiol Case Rep. 2024 May 6;19(8):3033-3037. doi: 10.1016/j.radcr.2024.03.043. eCollection 2024 Aug.
Presented here is a compelling case of a patient with a history of untreated hypertension, highlighting symptoms indicative of Wallenberg syndrome, including acute-onset dizziness, visual disturbances, continuous vomiting, difficulty walking, and an altered level of consciousness. This case's significance lies in its clinical presentation and in the diagnostic journey undertaken to elucidate its underlying pathology. Throughout the patient's hospitalization, a comprehensive assessment incorporating clinical, laboratory, and imaging techniques was conducted to delineate the extent of their condition. Of particular significance were the findings derived from MRI and MRA examinations of the endocranium, which provided crucial insights into the underlying pathophysiology. The MRI revealed multifocal ischemic lesions, pointing towards basilar artery thrombosis affecting both vertebral branches and displaying characteristic features associated with Wallenberg syndrome. Notably, the patient's lack of antihypertensive, anticoagulant, or antiplatelet therapy underscores the importance of addressing modifiable risk factors early in the disease course. This case serves as a poignant reminder of the complexities inherent in cerebrovascular diseases, highlighting the imperative of prompt recognition and management of predisposing factors. By presenting this case, we aim to underscore the clinical significance of timely intervention in mitigating potential complications of hypertension, such as cerebral artery thrombosis, thereby emphasizing the importance of proactive patient care and risk factor modification in clinical practice.
本文介绍了一例令人关注的病例，患者有未治疗的高血压病史，突出了提示延髓背外侧综合征的症状，包括急性发作的头晕、视觉障碍、持续呕吐、行走困难和意识水平改变。该病例的意义在于其临床表现以及为阐明其潜在病理所进行的诊断过程。在患者住院期间，进行了综合评估，包括临床、实验室和影像学检查，以明确其病情程度。颅内MRI和MRA检查的结果尤为重要，为潜在的病理生理学提供了关键见解。MRI显示多灶性缺血性病变，提示基底动脉血栓形成累及双侧椎动脉分支，并表现出与延髓背外侧综合征相关的特征。值得注意的是，患者未接受抗高血压、抗凝或抗血小板治疗，这凸显了在疾病病程早期应对可改变的危险因素的重要性。该病例深刻提醒人们脑血管疾病固有的复杂性，突出了及时识别和处理诱发因素的紧迫性。通过展示这个病例，我们旨在强调及时干预以减轻高血压潜在并发症（如脑动脉血栓形成）的临床意义，从而强调在临床实践中积极的患者护理和危险因素调整的重要性。
