Bilateral Hippocampal Infarction following Thrombectomy for Basilar Occlusion

2021 ◽  
Author(s):  
Sydni M. Cole ◽  
Jonah P. Zuflacht ◽  
Meghan McAnally ◽  
Magdy H. Selim
Keyword(s):  
Basilar Occlusion

Terapia fibrinolitica intra-arteriosa in occlusione vertebrobasilare acuta

1997 ◽  
Vol 10 (2_suppl) ◽  
pp. 207-210
Author(s):  
S. Mangiafico ◽  
G. Villa ◽  
G.P. Giordano ◽  
V. Scardigli ◽  
C. Pandolfo ◽  
...  
Keyword(s):  
Brain Stem ◽  
Clinical Signs ◽  
Fibrinolytic Therapy ◽  
Artery Occlusion ◽  
Acute Onset ◽  
Basilar Artery Occlusion ◽  
Cerebral Stroke ◽  
Clinical Onset ◽  
Vertebrobasilar Stroke ◽  
Basilar Occlusion

Intra-arterial fibrinolytic therapy in acute vertebrobasilar occlusion is effective in saving the patient's life in 75% of cases if performed within 6 hours after the beginning of an ischemic event, without CT evidence of hypodense focal areas in the brain stem, cerebellum or thalamic nucleus. The initial clinical aspect of vertebrobasilar stroke is more often evolving. Only in 1/3 of cases is coma present at the beginning. In vertebro-basilar occlusion prognosis is determined by clinical and neuroradiological aspects. The outcome depends mainly upon how much brain stem function is lost during the reperfusion time, and the kind of vertebrobasilar occlusion. The case we present concerns a 38 year old man with acute onset of cerebral stroke without initial clinical signs of vertebrobasilar localization due to a basilar artery occlusion distal to AICA. Urokinase infusion was performed within three hours from the clinical onset up to a total amount of 1.400.000 UI. Reperfusion was observed one hour after the beginning of the intravascular therapy. The clinical course was favorable with good recovery (moderate superior right paresis, controlateral light cerebellar syndrome).

scholarly journals HYPERDENSE BASILAR ARTERY – EARLY SIGN OF STROKE

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 46-47
Author(s):  
Mohammad Masood ◽  
Akshit Kumar ◽  
Omair Ashraf Shah ◽  
Feroz Shaheen
Keyword(s):  
Emergency Department ◽  
Facial Nerve ◽  
Basilar Artery ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Sudden Onset ◽  
Posterior Circulation ◽  
Clinical Scenario ◽  
Posterior Circulation Stroke ◽  
Basilar Occlusion

Hyperdense artery sign is presumed to represent acute thrombus or clot, and is an early indicator of posterior circulation stroke. This sign if detected, in proper clinical scenario can help the clinician to detect the basilar occlusion and to intervene early. We are presenting a case of 30 yr. old female, normotensive, nondiabetic presented with sudden onset focal left sided seizure, central vertigo, diplopia and decreased vision in left eye to emergency department. On examination, ptosis and anisocoria, Left facial nerve palsy. Patient was advised NCCT Head, which showed hyperdense basilar artery , seen retrospectively after MRI.    

scholarly journals Basilar Occlusion Syndromes

2015 ◽  
Vol 5 (3) ◽  
pp. 142-150 ◽  
Author(s):  
Stacie L. Demel ◽  
Joseph P. Broderick
Keyword(s):  
Basilar Occlusion

Abstract TMP5: Vessel Status Findings in Patient Candidates Transferred for Endovascular Treatment. Data From Catalonia’s Code Stroke Registry

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Alan Flores ◽  
Xavier Ustrell ◽  
Laia Seró ◽  
Anna Pellisé ◽  
Jaume Viñas ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Population Based ◽  
Time Intervals ◽  
Anterior Circulation ◽  
Stroke Registry ◽  
Lower Baseline ◽  
Treatment Data ◽  
Basilar Occlusion ◽  
Distal Occlusion

The aim of this study was to determine changes in vessel status between PSC and CSC according to site and occlusion level, rtPA-treatment, and pre-specified time intervals. Methods: Observational, multicenter study, from a prospective, government-mandated, population-based registry. We selected data from candidates to EVT with documented LVO at PSC who were transferred to CSC from January 2017 to June 2019. We used clinical variables and time intervals as the Symptom-Onset to Vascular-Imaging at CSC (SOTVI2). The primary endpoint was defined as no-occlusion/distal occlusion ineligible for EVT at CSC arrival (NOEVTatCSC) as was utilized. Results: From 589 patients, 37% received rtPA. Rate of NOEVTatCSC was 10.5% (n: 62) and 87% were treated with rtPA, being 35.8% of causes to exclude EVT at CSC arrival. In univariate analysis, lower baseline-NIHSS (median 12 vs. 16 p<0.01), RACE-scale (median 5 vs. 6; p=0.04) and SOTVI2-time (mean-minutes 268.7 vs. 317.2; p=0.04), rtPA treatment (13.7% Vs. 5.0%; p<0.01), and M2 occlusion (16.8% Vs. 9%; p= 0.02) were associated with NOEVTatCSC. In multivariate analysis, only rtPA-treatment was associated with NOEVTatCSC (OR: 4.65, 95%CI: 1.73-12.4, p= 0.003). In the rtPA subgroup, Basilar occlusion (28% Vs. 12%; p=0.04), lower baseline-NIHSS (13 Vs. 16; p<0.01) and SOTVI2 times ≤240 minutes (28.9% Vs. 15.4%; p=0.02) were associated with NOEVTatCSC. In Multivariate analysis SOVI2 ≤240 minutes (OR: 2.109 95%CI: 1.008-4.401, p=0.04) emerged as the only predictor of NOEVTatCSC. Changes in the vessel status according to initial occlusion at PSC in anterior circulation were observed, and occurred in both; proximal and distal direction. In 11.2% of cases, occlusion site at CSC was more proximal than at PSC. Conclusion: In patient candidates for EVT transferred from PSC to CSC, NOEVTatCSC is infrequent making the need of a second vascular study before the angiogram at CSC arguable. Despite of its modest effect, tPA-treatment at PSC is the only factor associated with NOEVTatCSC. This could be most relevant in basilar occlusions and in the first 4-hours. Changes in the vessel status according to initial occlusion in PSC occur in anterior circulation. Future studies addressed to determine factors related to these changes are warranted.

Vertebrobasilar Stroke, Cerebellar Stroke, and Basilar Occlusion

1994 ◽  
pp. 596-606 ◽  
Author(s):  
Andreas Ferbert ◽  
Michael S. Pessin ◽  
Klaus Rieke ◽  
Werner Hacke
Keyword(s):  
Cerebellar Stroke ◽  
Vertebrobasilar Stroke ◽  
Basilar Occlusion

Abstract 18: External Validation of the RACE Scale After Its Implementation in the Stroke Code Protocol in Catalonia

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Natalia Perez de la Ossa ◽  
Sonia Abilleira ◽  
Marc Ribó ◽  
Millan Monica ◽  
Pere Cardona ◽  
...  
Keyword(s):  
Validation Study ◽  
External Validation ◽  
Area Under The Curve ◽  
Final Diagnosis ◽  
Youden Index ◽  
Vessel Occlusion ◽  
Basilar Occlusion ◽  
Race 2 ◽  
Ischemic Attack ◽  
Sensitivity Specificity

Introduction: We aimed to revalidate the RACE scale as a pre-hospital tool to identify patients with large vessel occlusion (LVO) and patients receiving endovascular treatment (EVT) after its implementation in the Stroke Code protocol of Catalonia (7.5 M inhabitants). Methods: We used data from the CICAT registry (Feb to Jun 2016), a government-mandated, prospective, hospital-based dataset that includes all Stroke Code activations. CICAT is linked to the EMS database to capture information about the pre-hospital care. RACE score, pre-hospital and in-hospital delays, final diagnostic, presence of LVO (TICA, MCA M1 or M2, tandem or basilar occlusion) and revascularization treatment were registered. Sensitivity, specificity and area under the curve (AUC) to identify LVO and patients receiving EVT were calculated for the pre-established cut off RACE≥5. Results: From the 1600 stroke code activations we included in the study the 962 patients in which the RACE scale was available (60%). The RACE scale showed a strong correlation with the NIHSS evaluated at hospital arrival (r=0.74, p<0.001). Distribution of final diagnosis and median RACE scores were: ischemic with LVO (22.1%), RACE 7 [5-8], ischemic without LVO (29.3%), RACE 3 [2-5], hemorrhagic(17.8%), RACE 6 [4-7], mimic(21.0%), RACE 2 [1-4] and transient ischemic attack(9.7%), RACE 3 [1-5]. A RACE cut-off score ≥5 showed sensitivity 0.80 and specificity 0.63 to detect LVO (AUC 0.78, Youden index 0.45), similar to results obtained in the validation study. In patients with RACE≥5 the rates of LVO (42% Vs 9%;p<0.001) and EVT (21% Vs 6%;p<0.001) were significantly higher than in patients with RACE<5. Conclusion: This large validation study performed after implementation of the RACE scale in the real clinical practice in the region of Catalonia confirms RACE accuracy to identify candidates to EVT. A RACE score ≥5 detected 77% of patients that finally underwent EVT confirming the scale as a valuable tool at the prehospital level.

scholarly journals Impact of stroke mechanism in acute basilar occlusion with reperfusion therapy

2018 ◽  
Vol 5 (3) ◽  
pp. 357-368 ◽  
Author(s):  
Woo-Jin Lee ◽  
Keun-Hwa Jung ◽  
Young Jin Ryu ◽  
Jeong-Min Kim ◽  
Soon-Tae Lee ◽  
...  
Keyword(s):  
Reperfusion Therapy ◽  
Basilar Occlusion ◽  
Stroke Mechanism
Sign in / Sign up

Export Citation Format

Share Document