Ghapar Amirul Asyraf Abdul, Abd Kadir Khairul Azmi, Chu Grace Sze Ern, Tai Mei Ling Sharon, Idris Mohamad Imran, New Ru Peng, Zainal Abidin Imran, Goh Khean Jin, Tan Kay Sin
Division of Neurology, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Cerebrovasc Dis Extra. 2025;15(1):73-80. doi: 10.1159/000543418. Epub 2025 Jan 8.
This case report illustrates the complexities of arrhythmogenic right ventricular cardiomyopathy (ARVC) and its thromboembolic complications resulting in top-of-basilar artery syndrome. We discuss the case of a 37-year-old male with ARVC who presented with acute onset of dizziness, imbalance, and vomiting, leading to the diagnosis of a top-of-basilar artery occlusion (BAO) which was successfully treated.
This case highlights the diagnostic and acute treatment challenges in BAO due to its non-specific symptoms and emphasizes the critical role of CT angiography in detecting occlusive thrombi for timely intervention. With prompt endovascular thrombectomy and bridging intravenous thrombolysis, complete recanalization was achieved and the patient was discharged with modified Rankin Scale (mRS) of 1. Effective management strategies involve assessing ventricular function, detecting arrhythmias, identifying intracardiac thrombi, and implementing individualized stroke prevention measures, such as using direct oral anticoagulants.
This study illustrates the necessity of a multidisciplinary approach in optimizing patient outcomes in acute stroke care. Focusing on the rare condition of ARVC and the specific challenge of top-of-BAOs in this case underscores the intricate interplay between cardiovascular and cerebrovascular pathology leading to improved understanding and management of these conditions.
This case report illustrates the complexities of arrhythmogenic right ventricular cardiomyopathy (ARVC) and its thromboembolic complications resulting in top-of-basilar artery syndrome. We discuss the case of a 37-year-old male with ARVC who presented with acute onset of dizziness, imbalance, and vomiting, leading to the diagnosis of a top-of-basilar artery occlusion (BAO) which was successfully treated.
This case highlights the diagnostic and acute treatment challenges in BAO due to its non-specific symptoms and emphasizes the critical role of CT angiography in detecting occlusive thrombi for timely intervention. With prompt endovascular thrombectomy and bridging intravenous thrombolysis, complete recanalization was achieved and the patient was discharged with modified Rankin Scale (mRS) of 1. Effective management strategies involve assessing ventricular function, detecting arrhythmias, identifying intracardiac thrombi, and implementing individualized stroke prevention measures, such as using direct oral anticoagulants.
This study illustrates the necessity of a multidisciplinary approach in optimizing patient outcomes in acute stroke care. Focusing on the rare condition of ARVC and the specific challenge of top-of-BAOs in this case underscores the intricate interplay between cardiovascular and cerebrovascular pathology leading to improved understanding and management of these conditions.
本病例报告阐述了致心律失常性右室心肌病（ARVC）的复杂性及其血栓栓塞并发症导致基底动脉尖综合征的情况。我们讨论了一名37岁患有ARVC的男性病例，该患者出现急性头晕、失衡和呕吐症状，最终诊断为基底动脉尖闭塞（BAO），并成功接受了治疗。
该病例突出了BAO因其非特异性症状所带来的诊断和急性治疗挑战，并强调了CT血管造影在检测闭塞性血栓以便及时干预方面的关键作用。通过及时的血管内血栓切除术和桥接静脉溶栓治疗，实现了完全再通，患者出院时改良Rankin量表（mRS）评分为1分。有效的管理策略包括评估心室功能、检测心律失常、识别心内血栓以及实施个体化的卒中预防措施，如使用直接口服抗凝剂。
本研究说明了在优化急性卒中护理患者预后方面采用多学科方法的必要性。关注本病例中ARVC这一罕见病症以及基底动脉尖闭塞的特殊挑战，凸显了心血管和脑血管病理学之间复杂的相互作用，有助于增进对这些病症的理解和管理。
本病例报告阐述了致心律失常性右室心肌病（ARVC）的复杂性及其血栓栓塞并发症导致基底动脉尖综合征的情况。我们讨论了一名37岁患有ARVC的男性病例，该患者出现急性头晕、失衡和呕吐症状，最终诊断为基底动脉尖闭塞（BAO），并成功接受了治疗。
该病例突出了BAO因其非特异性症状所带来的诊断和急性治疗挑战，并强调了CT血管造影在检测闭塞性血栓以便及时干预方面的关键作用。通过及时的血管内血栓切除术和桥接静脉溶栓治疗，实现了完全再通，患者出院时改良Rankin量表（mRS）评分为1分。有效的管理策略包括评估心室功能、检测心律失常、识别心内血栓以及实施个体化的卒中预防措施，如使用直接口服抗凝剂。
本研究说明了在优化急性卒中护理患者预后方面采用多学科方法的必要性。关注本病例中ARVC这一罕见病症以及基底动脉尖闭塞的特殊挑战，凸显了心血管和脑血管病理学之间复杂的相互作用，有助于增进对这些病症的理解和管理。
