Progression of In Situ Thrombosis of Basilar Artery.
- Author:
Byung Gon KIM
1
;
Chin Sang CHUNG
;
Kwang Ho LEE
Author Information
1. Department of Neurology, Samsung Medical Center.
- Publication Type:Original Article
- MeSH:
Angiography;
Ataxia;
Basilar Artery*;
Dehydration;
Disorders of Excessive Somnolence;
Dysarthria;
Humans;
Neurologic Manifestations;
Paresis;
Risk Factors;
Thrombosis*;
Vertigo
- From:Journal of the Korean Neurological Association
1996;14(4):889-899
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The clinical and radiological characteristics of progressing in situ thrombosis of the basilar artery have poorly been described. Patients with such condition present with minor neurologic deficits initially, progress in the hospital over several days, and present poor outcomes. We tried to find the common features of those patients that might have been associated with progression. We investigated the clinical pictures, risk factors, possible triggering factors, managements, and radiological data of seven patients whose basilar artery thrombosis progressed in the hospital after having presented with minor neurological deficits at first. The initial clinical presentations included dysarthria plus hemiparesis in four, vertigo plus ataxia in two, and hypersomnolence without sensorimotor deficits in one. In four patients the neurological progressions were preceded by clinical events that might have caused dehydration. On MR angiography (MRA) performed in five, the basilar artery was barely visible in all. Only one patient was under adequate anticoagulation. Intraarterial thrombolysis was done in two patients with partial improvement in one. In conclusion, poor visualization of the basilar artery on MRA may be a strong indicator of early progression of in situ thrombosis. Since dehydration may play as a trigger, sufficient hydration seems to be the best strategy in addition to adequate anticoagulation when basilar artery thrombosis is suspected clinically and radiologically. Once if clinical progression occurs, Intraarterial thrombolysis may be tried.
