Τίτλος:
Bilateral paramedian midbrain infarct: an uncommon variant of the ``top
of the basilar'' syndrome
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Occlusion of the rostral portion of the basilar artery can result in
ischaemia of the midbrain and thalami, as well as of the temporal and
occipital lobes. The so called “top of the basilar” syndrome
manifests clinically as numerous combinations of abnormalities of
alertness, sleep-wake cycle, and behaviour and oculomotor or
pupillomotor functions. A 67 year old man presented with bilateral
internuclear ophthalmoplegia, rubral tremor, and daytime somnolence. He
was awake during the night and mostly agitated and aggressive. An
ischaemic lesion was visible on the magnetic resonance (MR) image in the
central portion of the midbrain just ventral to the aqueduct, clearly
affecting the paramedian structures bilaterally. MR angiographic images
demonstrated a hypoplastic basilar artery ending in both superior
cerebellar arteries. Both posterior cerebral arteries were seen to arise
from the corresponding internal carotid arteries via the posterior
communicating branches. This unique case of an acute bilateral
paramedian infarct represents a highly uncommon variant of the “top of
the basilar” syndrome and was due to the affected ischaemic territory
- that is, the “distal field” of the variant basilar artery.
Συγγραφείς:
Spengos, K
Wohrle, JC
Tsivgoulis, G
Stouraitis, G and
Vemmos, K
Zis, V
Περιοδικό:
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
Εκδότης:
B M J PUBLISHING GROUP
DOI:
10.1136/jnnp.2004.050146
