Progression of In Situ Thrombosis of Basilar Artery

J Korean Neurol Assoc > Volume 14(4); 1996 > Article

Journal of the Korean Neurological Association 1996;14(4): 889-899.

기저동맥 혈전증의 진행에 관한 연구

김병곤, 정진상 이광호

삼성의료원 신경과, 서울대학병원 신경과*

Progression of In Situ Thrombosis of Basilar Artery

Byung-gon Kim*, Chin-sang chung, Kwang-ho Lee

Department of Neurology, Samsung Medical Center and Seoul National University Hospital*

Abstract

The clinical and radiological characteristics of progressing in situ thrombosis of the basilar artery have poorly been described. Patients with such condition present with minor neurologic deficits initially, progress in the hospital over several days, and present poor outcomes. We tried to find the common features of those patients that might have been associated with progression. We investigated the clinical pictures, risk factors, possible triggering factors, managements, and radiological data of seven patients whose basilar artery thrombosis progressed in the hospital after having presented with minor neurological deficits at first. The initial clinical presentations included dysarthria plus hemiparesis in four, vertigo plus ataxia in two, and hypersomnolence without sensorimotor deficits in one. In four patients the neurological progressions were preceded by clinical events that might have caused dehydration. On MR angiography (MRA) performed in five, the basilar artery was barely visible in all. Only one patient was under adequate anticoagulation. Intraarterial thrombolysis was done in two patients with partial improvement in one. In conclusion, poor visualization of the basilar artery on MRA may be a strong indicator of early progression of in situ thrombosis. Since dehydration may play as a trigger, sufficient hydration seems to be the best strategy in addition to adequate anticoagulation when basilar artery thrombosis is suspected clinically and radiologically. Once if clinical progression occurs, Intraarterial thrombolysis may be tried.