Case Report
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İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu

Year 2022, Volume: 11 Issue: 2, 264 - 268, 31.08.2022
https://doi.org/10.47493/abantmedj.975660

Abstract

Servikal, vertebral ve kranial arter diseksiyonu iskemik inmede nadir görülen bir etiyolojidir. Bu olgu sunumunda pons inmesi tanısı alan spontan baziler arter diseksiyonu olgusunu güncel literatür eşliğinde tartışmayı amaçladık. Elli iki yaşında erkek hasta kliniğimize senkop sonrası bilin kaybı nedeni ile getirildi. Fizik muayenede bilinç kapalı idi ve Glasgow koma skoru 9 (verbal 3, motor 3, göz 3) olarak değerlendirildi. Orotrakeal entübasyon sonrası intravenöz kontrastlı beyin bilgisayarlı tomografi görüntülemesi yapıldı. İntravenöz kontrastlı beyin bilgisayarlı tomografide baziler arter seviyesinde trombus formasyonu ve olası diseksiyon filebi izlendi. Kranial dijital substraksiyon anjiyografi yapılan hastada basiller arter diseksiyonu doğrulandı. Hastaya endovasküler trombektomi uygulandı. Yetmiş yedi günlük hasta yatışı ardından hasta taburcu edildi. Sonuç olarak; baziler arter diseksiyonları, önemli morbidite ve ölümle ilişkilendirilen nadir lezyonlardır. Baziler arter diseksiyonunun benign seyri ve tedavi seçenekleri perforan dalları ve lokalizasyonu nedeniyle diğer diseksiyonlarından önemli ölçüde farklıdır.

References

  • 1) Blum CA, Yaghi S. Cervical Artery Dissection: A Review of the Epidemiology, Pathophysiology, Treatment, and Outcome. Arch Neurosci. 2015;2(4):e26670. doi:10.5812/archneurosci.26670.
  • 2) Smajlović D. Strokes in young adults: epidemiology and prevention. Vasc Health Risk Manag. 2015;11:157-164. Published 2015 Feb 24. doi:10.2147/VHRM.S53203.
  • 3) Haneline MT, Rosner AL. The etiology of cervical artery dissection. J Chiropr Med. 2007;6(3):110-120. doi:10.1016/j.jcme.2007.04.007.
  • 4) Moyer JD, Dioguardi Burgio M, Abback PS, et al. Isolated basilar artery dissection following blunt trauma challenging the Glasgow coma score: A case report. Am J Emerg Med. 2021 Mar 8:S0735-6757(21)00193-5. doi: 10.1016/j.ajem.2021.03.008.
  • 5) Masson C, Krespy Y, Masson M, et al. Magnetic resonance imaging in basilar artery dissection. Stroke 1993; 24:1264–6.
  • 6) Nakahara T, Satoh H, Mizoue T, et al. Dissecting aneurysm of basilar artery presenting with recurrent subarachnoid hemorrhage. Neurosurg Rev 1999; 22:155–8
  • 7) Ali MJ, Bendok BR, Tella MN, et al. Arterial reconstruction by direct surgical clipping of a basilar artery dissecting aneurysm after failed vertebral artery occlusion: technical case report and literature review. Neurosurgery 2003;52:1475–81
  • 8) Kim BM, Suh SH, Park SI, et al. Management and clinical outcome of acute basilar artery dissection. AJNR Am J Neuroradiol. 2008 Nov;29(10):1937-41. doi: 10.3174/ajnr.A1243.
  • 9) Fiorella D, Albuquerque FC, Deshmukh VR, et al. Endovascular reconstruction with the Neuroform stent as monotherapy for the treatment of uncoilable intradural pseudoaneurysm. Neurosurgery 2006;59:291–300.
  • 10) Benndorf G, Herbon U, Sollmann WP, et al. Treatment of a ruptured dissecting vertebral artery aneurysm with double stent placement: case report. AJNR Am J Neuroradiol 2001;22:1844–8.

Isolated Spontaneous Basilar Artery Dissection: A Case Report

Year 2022, Volume: 11 Issue: 2, 264 - 268, 31.08.2022
https://doi.org/10.47493/abantmedj.975660

Abstract

Cervical, vertebral and cranial artery dissection is a rare etiology of ischemic stroke. In this case report, we aimed to discuss a case of spontaneous basilar artery dissection presenting with pons stroke in the light of current literature. A 52-year-old male patient was brought to our clinic because of loss of consciousness after syncope. Physical examination showed he was unconscious and had Glasgow coma score of 9 (verbal 3, motor 3, eye 3). Brain computed tomography imaging with intravenous contrast was performed after orotracheal intubation. Thrombus formation at the level of the basilar artery and possible dissection phleb were observed in the brain computed tomography with intravenous contrast. Bacillary artery dissection was confirmed in the patient who underwent cranial digital subtraction angiography. The patient underwent endovascular thrombectomy. The patient was discharged after seventy-seven days of hospitalization. As a conclusion; basilar artery dissections are rare lesions associated with significant morbidity and death. The nature and treatment options of basilar artery dissection are significantly different from other dissections due to its perforating branches and localization.

References

  • 1) Blum CA, Yaghi S. Cervical Artery Dissection: A Review of the Epidemiology, Pathophysiology, Treatment, and Outcome. Arch Neurosci. 2015;2(4):e26670. doi:10.5812/archneurosci.26670.
  • 2) Smajlović D. Strokes in young adults: epidemiology and prevention. Vasc Health Risk Manag. 2015;11:157-164. Published 2015 Feb 24. doi:10.2147/VHRM.S53203.
  • 3) Haneline MT, Rosner AL. The etiology of cervical artery dissection. J Chiropr Med. 2007;6(3):110-120. doi:10.1016/j.jcme.2007.04.007.
  • 4) Moyer JD, Dioguardi Burgio M, Abback PS, et al. Isolated basilar artery dissection following blunt trauma challenging the Glasgow coma score: A case report. Am J Emerg Med. 2021 Mar 8:S0735-6757(21)00193-5. doi: 10.1016/j.ajem.2021.03.008.
  • 5) Masson C, Krespy Y, Masson M, et al. Magnetic resonance imaging in basilar artery dissection. Stroke 1993; 24:1264–6.
  • 6) Nakahara T, Satoh H, Mizoue T, et al. Dissecting aneurysm of basilar artery presenting with recurrent subarachnoid hemorrhage. Neurosurg Rev 1999; 22:155–8
  • 7) Ali MJ, Bendok BR, Tella MN, et al. Arterial reconstruction by direct surgical clipping of a basilar artery dissecting aneurysm after failed vertebral artery occlusion: technical case report and literature review. Neurosurgery 2003;52:1475–81
  • 8) Kim BM, Suh SH, Park SI, et al. Management and clinical outcome of acute basilar artery dissection. AJNR Am J Neuroradiol. 2008 Nov;29(10):1937-41. doi: 10.3174/ajnr.A1243.
  • 9) Fiorella D, Albuquerque FC, Deshmukh VR, et al. Endovascular reconstruction with the Neuroform stent as monotherapy for the treatment of uncoilable intradural pseudoaneurysm. Neurosurgery 2006;59:291–300.
  • 10) Benndorf G, Herbon U, Sollmann WP, et al. Treatment of a ruptured dissecting vertebral artery aneurysm with double stent placement: case report. AJNR Am J Neuroradiol 2001;22:1844–8.
There are 10 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Case Report
Authors

Serdar Özdemir 0000-0002-6186-6110

Abuzer Özkan 0000-0002-8053-9975

Hatice Akça 0000-0003-2823-9577

Abdullah Algın 0000-0002-9016-9701

Publication Date August 31, 2022
Submission Date July 28, 2021
Published in Issue Year 2022 Volume: 11 Issue: 2

Cite

APA Özdemir, S., Özkan, A., Akça, H., Algın, A. (2022). İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu. Abant Medical Journal, 11(2), 264-268. https://doi.org/10.47493/abantmedj.975660
AMA Özdemir S, Özkan A, Akça H, Algın A. İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu. Abant Med J. August 2022;11(2):264-268. doi:10.47493/abantmedj.975660
Chicago Özdemir, Serdar, Abuzer Özkan, Hatice Akça, and Abdullah Algın. “İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu”. Abant Medical Journal 11, no. 2 (August 2022): 264-68. https://doi.org/10.47493/abantmedj.975660.
EndNote Özdemir S, Özkan A, Akça H, Algın A (August 1, 2022) İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu. Abant Medical Journal 11 2 264–268.
IEEE S. Özdemir, A. Özkan, H. Akça, and A. Algın, “İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu”, Abant Med J, vol. 11, no. 2, pp. 264–268, 2022, doi: 10.47493/abantmedj.975660.
ISNAD Özdemir, Serdar et al. “İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu”. Abant Medical Journal 11/2 (August 2022), 264-268. https://doi.org/10.47493/abantmedj.975660.
JAMA Özdemir S, Özkan A, Akça H, Algın A. İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu. Abant Med J. 2022;11:264–268.
MLA Özdemir, Serdar et al. “İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu”. Abant Medical Journal, vol. 11, no. 2, 2022, pp. 264-8, doi:10.47493/abantmedj.975660.
Vancouver Özdemir S, Özkan A, Akça H, Algın A. İzole Spontan Baziler Arter Diseksiyonu: Olgu Sunumu. Abant Med J. 2022;11(2):264-8.