Hashimoto Y, Kimura K, Dohsaka A, Terasaki T, Uchino M
Department of Neurology, Kumamoto City Hospital, Japan.
Rinsho Shinkeigaku. 1995 Nov;35(11):1225-9.
An 85-year-old man who did not have any previous history of heart disease was admitted to our hospital with the chief complaints of disturbance of consciousness, tetraparesis, and bilateral Babinski signs. On admission, intravenous digital subtraction angiography (DSA) showed bilatral vertebral arteries without filling the basilar artery. On the second hospital day, MRI showed a septum in the basilar artery, and no infarctions were noted in the brain stem. He gradually improved with heparin therapy. On the tenth hospital day, intravenous DSA disclosed filling of the basilar artery. On the sixteenth hospital day, conventional cerebral angiography revealed filling of the basilar artery from the left vertebral artery, and string sign and linear shadow (intimal flap) was noted in the basilar artery. He was diagnosed to have the basilar artery dissection. The patient became ambulatory and was discharged independently. This is very rare case of the basilar artery dissection with a good prognosis.
一名85岁男性,既往无心脏病史,因意识障碍、四肢瘫及双侧巴宾斯基征为主诉入院。入院时,静脉数字减影血管造影(DSA)显示双侧椎动脉未充盈基底动脉。入院第二天,MRI显示基底动脉有隔膜,脑干未见梗死灶。经肝素治疗后病情逐渐好转。入院第十天,静脉DSA显示基底动脉充盈。入院第十六天,传统脑血管造影显示基底动脉由左椎动脉充盈,基底动脉可见串珠征和线状阴影(内膜瓣)。诊断为基底动脉夹层。患者能够行走并独立出院。这是一例非常罕见的基底动脉夹层且预后良好的病例。