Akram Muhammad Rizwan, Veena Fnu, Sabah Afroze Fnu, Peachey Matthew, Elkin Rene
Internal Medicine, BronxCare Health System, New York, USA.
Neurology, BronxCare Health System, New York, USA.
Cureus. 2025 Mar 3;17(3):e79947. doi: 10.7759/cureus.79947. eCollection 2025 Mar.
A 76-year-old man with poorly controlled diabetes mellitus, with an HbA1c of 10.9% (4.7%-6.4%), presents with acute right facial numbness, transient right eye foggy vision, and near syncope. Neuroimaging revealed substantial basilar artery stenosis with acute infarction in the region of the right posterior cerebral artery, impacting the medial temporal, occipital, thalamus, and midbrain. Although basilar artery stenosis is uncommon, its combination with poorly managed diabetes and posterior circulation involvement makes therapy difficult. Partial neurological recovery was observed with dual antiplatelet treatment and intensive risk factor management. Basilar artery stenosis has a poor prognosis; however, early detection, medical therapy, and comorbidity control can improve patient outcomes and reduce recurrence risk. The example further emphasizes the necessity of preventative treatment in high-risk patients and the link between diabetes control and posterior circulation stroke risk.
一名76岁男性，糖尿病控制不佳，糖化血红蛋白（HbA1c）为10.9%（4.7%-6.4%），出现急性右侧面部麻木、右眼短暂视物模糊及近乎晕厥。神经影像学检查显示基底动脉严重狭窄，右侧大脑后动脉区域有急性梗死，累及颞叶内侧、枕叶、丘脑和中脑。尽管基底动脉狭窄并不常见，但它与糖尿病管理不善及后循环受累相结合使得治疗困难。通过双重抗血小板治疗和强化危险因素管理，观察到部分神经功能恢复。基底动脉狭窄预后不良；然而，早期检测、药物治疗和合并症控制可改善患者预后并降低复发风险。该病例进一步强调了高危患者预防性治疗的必要性以及糖尿病控制与后循环卒中风险之间的联系。
