Transient Locked-in Syndrome and Basilar Artery Vasospasm.
Summary of "Transient Locked-in Syndrome and Basilar Artery Vasospasm."
BACKGROUND:
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.
METHODS:
We report the case of a 43 years-old man with BAVS presenting as a reversible locked-in syndrome (LIS) after stopping sedation.
RESULTS:
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.
CONCLUSION:
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.
Affiliation
Department of Anesthesiology and Intensive Care, Sainte Anne Teaching Military Hospital, Toulon, France.
Journal Details
This article was published in the following journal.
Name: Neurocritical care
ISSN: 1556-0961
Pages:
Links
- 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.
Basilar Artery
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.
Amaurosis Fugax
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)
Basilar Membrane
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.
PubMed Articles
Inflammation and immunity play a crucial role in the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage (SAH). CD137 is recognized as an independent costimulatory molecule of T cells and...
BACKGROUND: Delayed cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is a major cause of high morbidity and mortality. The reduced availability of nitric oxide (NO) in blood and cereb...
Potential role of Ras in cerebral vasospasm after experimental subarachnoid hemorrhage in rabbits.
Previous studies have demonstrated that mitogen-activated protein kinase (MAPK) is involved in the pathogenesis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Ras, an upstream r...
Potential role of CD34 in cerebral vasospasm after experimental subarachnoid hemorrhage in rats.
Inflammatory responses have been implicated in the elaboration of several forms of central nervous system injury, including cerebral vasospasm after subarachnoid hemorrhage (SAH). A critical event par...
Clinical Trials
Dose Comparison Study of Topiramate in Pediatric Subjects With Basilar/Hemiplegic Migraine
The objective of this study is to assess the effectiveness and safety of topiramate in the prevention of basilar and hemiplegic migraine in children and adolescents.
A Study of Topiramate in Pediatric Subjects With Basilar/Hemiplegic Migraine
The objective of this study is to assess the long-term safety and effectiveness of topiramate in the prevention of basilar and hemiplegic migraine in children and adolescents.
Insights in the Pathophysiology of Transient Left Ventricular Ballooning Syndrome (TLVBS)
Transient left ventricular ballooning syndrome (TLVBS) is a cardiac syndrome that is characterised by acute but transient left ventricular (LV) dysfunction. Since the syndrome clearly is...
Therapeutic Effect of Sildenafil in Patients With Coronary Vasospasm
This will be a prospective, phase IIIb, double-blind and randomized trial testing the effect of single dose sildenafil application in patients with coronary vasospasm compared to placebo a...
Safety Study of Dantrolene to Treat Cerebral Vasospasm After Subarachnoid Hemorrhage
Subarachnoid hemorrhage (SAH) is a devastating acute brain injury due to bleeding onto the brain surface from a ruptured aneurysm. Cerebral vasospasm (cVSP; critical narrowing of brain art...
