Clinical characteristics and prognosis analysis of patients with basilar artery occlusion presenting with paroxysmal sympathetic hyperactivity as an initial manifestation
10.3760/cma.j.cn113694-20250618-00359
- VernacularTitle:阵发性交感神经过度兴奋作为初始表现的基底动脉闭塞患者的临床特征与预后分析
- Author:
Juntao YIN
1
;
Yanan JIA
;
Li FENG
;
Yu WANG
;
Wan WANG
;
Peng ZHAO
;
Yichao HUO
;
Yuqing WEI
Author Information
1. 邢台市中心医院神经内科，邢台 054000
- Publication Type:Journal Article
- Keywords:
Basilar Artery;
Arterial occlusive diseases;
Paroxysmal sympathetic hyperactivity;
Endovascular treatment
- From:
Chinese Journal of Neurology
2025;58(9):956-962
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the incidence, clinical characteristics, and prognosis of basilar artery occlusion (BAO) patients presenting with paroxysmal sympathetic hyperactivity (PSH) as an initial symptom.Methods:A retrospective analysis was conducted on BAO patients with PSH manifestations who received endovascular treatment at Xingtai Central Hospital between January 2018 and August 2024. Demographic characteristics, clinical data, imaging findings, and follow-up information were collected.Results:A total of 136 BAO patients were included, of whom 22 cases (16.2%) were diagnosed with PSH. The age of the patients was (56.81±9.92) years, with males accounting for 86.4%(19/22). On admission, the Glasgow Coma Scale score was 4(3, 5), and the National Institutes of Health Stroke Scale score was 30(25, 35). The successful reperfusion (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 90.9%(20/22). In-hospital mortality was 50.0%(11/22), symptomatic hemorrhagic transformation occurred in 4.5% (1/22), and any type of intracranial hemorrhage occurred in 9.1%(2/22). Clinical features of PSH included tachycardia, tachypnea, hypertension, fever, diaphoresis, and increased muscle tone. Imaging analysis showed a high proportion of cerebellar (100.0%, 22/22) and midbrain (72.7%, 16/22) involvement. The 90-day follow-up showed that 72.7%(16/22) of the patients had poor functional outcomes (modified Rankin Scale score of 4-6), and the 90-day mortality rate was 59.1%(13/22).Conclusions:Among patients with BAO undergoing endovascular therapy, the incidence of PSH as the initial manifestation was 16.2%(22/136). These patients were predominantly middle-aged men and commonly presented with tachycardia, tachypnea, hypertension, fever, diaphoresis, and increased muscle tone. Imaging findings mainly involved the cerebellum and midbrain. Despite a relatively high rate of recanalization, patients with PSH exhibited a higher risk of mortality and poor functional outcomes.
