scholarly journals Transient Anarthria and Quadriplegia in a Patient with Basilar Artery Hypoplasia and Coincidental Intracranial Lipoma: A Case Report

2018 ◽  
Vol 10 (3) ◽  
pp. 322-327
Author(s):  
Kyu-On Jung ◽  
Seung-Jae Lee ◽  
Hyung Jun Kim ◽  
Deokhyun Heo ◽  
Jeong-Ho Park
Keyword(s):  
Basilar Artery ◽  
Holter Monitoring ◽  
Sudden Onset ◽  
Predisposing Factor ◽  
Ischemic Lesion ◽  
Tomographic Images ◽  
Intracranial Lipoma ◽  
Computed Tomographic ◽  
Vertebrobasilar System ◽  
Ischemic Attack

Cerebral ischemia may be rarely associated with a hypoplastic vertebrobasilar system. Intracranial lipoma is also a very rare congenital malformation. We report the case of a 52-year-old woman with vertebrobasilar transient ischemic attack associated with basilar artery hypoplasia and coincidental intracranial lipoma. She presented with sudden-onset dizziness, anarthria, and quadriplegia lasting for about 30 min. The patient’s initial blood pressure was measured at 200/120 mm Hg. The magnetic resonance and computed tomographic images showed the absence of an acute ischemic lesion in the brain but revealed a hypoplasia of the basilar artery and bilateral V4 vertebral arteries. A lipoma of 11 mm in long diameter was also found in the quadrigeminal cistern and at the superior vermis. The electroencephalography, transthoracic echocardiogram, 24-h Holter monitoring, and transcranial Doppler ultrasonography, including patent foramen ovale study, were all noted as negative. The patient was treated with oral aspirin 100 mg, atorvastatin 10 mg, and antihypertensive medication. She had no symptom recurrence after the treatment. Our case suggests that hypoplasia of the vertebrobasilar arteries can be a predisposing factor for posterior circulation ischemia, especially when additional vascular risk factors coexist.

Utility of Three-dimensional Computed Tomographic Angiography for Assessment of Relationships between the Vertebrobasilar System and the Cranial Base

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 318-327 ◽  
Author(s):  
Alan T. Villavicencio ◽  
Linda Gray ◽  
Jean-Christophe Leveque ◽  
Takanori Fukushima ◽  
Sohaib Kureshi ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Three Dimensional ◽  
Cranial Base ◽  
Computed Tomographic Angiography ◽  
Conventional Angiography ◽  
Computed Tomographic ◽  
Vertebrobasilar System ◽  
Tomographic Angiography ◽  
Relationship Of ◽  
The Relationship

Abstract OBJECTIVE The optimal surgical exposure for basilar tip aneurysms is dictated by the relationship of the basilar bifurcation to the cranial base. This study was designed to evaluate three-dimensional computed tomographic angiography as a means of obtaining detailed anatomic information on the basilar artery and the surrounding cranial base in individual patients before surgery. METHODS We studied 30 patients using three-dimensional computed tomographic angiographic reconstructions from 1-mm computed tomographic slices. Detailed anatomic measurements were performed to define the relationship between the basilar artery and the cranial base. Particular attention was paid to the height of the dorsum sellae and its relationship to the basilar bifurcation. RESULTS The heights of the basilar apex and the vertebrobasilar junction, relative to the cranial base, were extremely variable. Considerable asymmetries in the heights of the left and right posterior clinoid processes were identified; in one case, this difference was more than 1 cm (mean difference in height, 0.9 mm; range, 0–10.3 mm). The heights of the posterior clinoid processes above the sellar floor ranged from 5.8 to 14.1 mm (mean height, 9.5 mm). We were able to determine the feasibility of the pterional/orbitozygomatic, middle fossa/anterior petrosal, and presigmoid retrolabyrinthine approaches to an individual basilar bifurcation. We also estimated the amount of bone removal required and determined the operative distances via those approaches. CONCLUSION Three-dimensional computed tomographic angiography is a useful tool for assessing critical anatomic relationships and represents an adjunct to conventional angiography in the planning of individualized, precisely tailored, cranial base approaches to the vertebrobasilar system.

scholarly journals Sudden Bilateral Deafness in a Patient with Transient Ischemic Attack: A Case Report

2021 ◽  
pp. 119-122
Author(s):  
Caroline Ellinore Pihl ◽  
Christina Fredsby Back ◽  
Helle Klingenberg Iversen ◽  
Faisal Mohammad Amin
Keyword(s):  
Hearing Loss ◽  
Insular Cortex ◽  
Sudden Onset ◽  
Acute Onset ◽  
Motor Deficits ◽  
Ischemic Lesion ◽  
Ischemic Attack ◽  
The Right ◽  
Bilateral Deafness ◽  
Rare Symptom

Sudden-onset bilateral cortical deafness is a very rare symptom of stroke, but must be recognized as stroke, as it is a treatable condition, and the treatment is highly time dependent. We report a 53-year-old man with an acute onset of complete bilateral hearing loss that gradually improved spontaneously over 4 h. The hearing loss was explained by an infarction visualized on magnetic resonance imaging, which showed a subacute temporoparietal ischemic lesion in the left cerebral hemisphere involving the insular cortex and an older infarction in the right temporoparietal region. The location of these kinds of lesions may typically not cause motor deficits, but sensory and cognitive (e.g., aphasia) symptoms, which can be challenging to recognize in a suddenly deaf patient. Taking the possible differential diagnoses into account, immediate stroke workup should always be prioritized in patients with sudden bilateral deafness, as acute revascularizing treatment is possible.

A ruptured aneurysm at the distal end of the basilar artery fenestration associated with multiple fenestrations of the vertebrobasilar system: Case report

1997 ◽  
Vol 47 (5) ◽  
pp. 469-472 ◽  
Author(s):  
Miki Fujimura ◽  
Takayuki Sugawara ◽  
Hiroshi Higuchi ◽  
Tatsuya Oku ◽  
Hirobumi Seki
Keyword(s):  
Case Report ◽  
Basilar Artery ◽  
Ruptured Aneurysm ◽  
Vertebrobasilar System
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