Transient Locked-in Syndrome and Basilar Artery Vasospasm.
Summary of "Transient Locked-in Syndrome and Basilar Artery Vasospasm."
Cerebral vasospasm is the main cause of neurological mortality and morbidity following subarachnoid hemorrhage. Basilar artery vasospasm (BAVS) is associated with a high morbidity and may have multiple clinical presentations.
We report the case of a 43 years-old man with BAVS presenting as a reversible locked-in syndrome (LIS) after stopping sedation.
The symptoms were successfully managed by intra-arterial infusion of vasodilators and balloon angioplasty. Magnetic resonance imaging did not reveal any brainstem lesion 48 h after the complication, demonstrating a hemodynamic mechanism.
LIS can reveal BAVS. Its diagnosis relies on clinical examination. In this case, rapid neuro-interventional treatment permitted reversal of symptoms. This could not have been possible under sedation.
Department of Anesthesiology and Intensive Care, Sainte Anne Teaching Military Hospital, Toulon, France.
This article was published in the following journal.
Name: Neurocritical care
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22131170
- DOI: http://dx.doi.org/10.1007/s12028-011-9655-z
Medical and Biotech [MESH] Definitions
Posterior Cerebral Artery
Artery formed by the bifurcation of the BASILAR ARTERY. Branches of the posterior cerebral artery supply portions of the OCCIPITAL LOBE; PARIETAL LOBE; inferior temporal gyrus, brainstem, and CHOROID PLEXUS.
The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries.
Superior Mesenteric Artery Syndrome
DUODENAL OBSTRUCTION by the superior mesenteric artery (MESENTERIC ARTERY, SUPERIOR) which travels in the root of the MESENTERY and crosses over the DUODENUM. The syndrome is characterized by the dilated proximal duodenum and STOMACH, bloating, ABDOMINAL CRAMPS, and VOMITING. Often it is observed in patient with body casts after spinal surgery.
Transient complete or partial monocular blindness due to retinal ischemia. This may be caused by emboli from the CAROTID ARTERY (usually in association with CAROTID STENOSIS) and other locations that enter the central RETINAL ARTERY. (From Adams et al., Principles of Neurology, 6th ed, p245)
A basement membrane in the cochlea that supports the hair cells of the ORGAN OF CORTI, consisting keratin-like fibrils. It stretches from the SPIRAL LAMINA to the basilar crest. The movement of fluid in the cochlea, induced by sound, causes displacement of the basilar membrane and subsequent stimulation of the attached hair cells which transform the mechanical signal into neural activity.
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