Mechanical thrombectomy in acute stroke due to occlusion of the basilar artery
DOI:
https://doi.org/10.62305/biosana.v4i4.246Keywords:
basilar artery occlusion; ischemic stroke; mechanical thrombectomyAbstract
Posterior territory stroke is associated with a mortality rate of up to 90% due to a delay in diagnosis, it is explained by the ambiguity of its clinical presentation and subtle signs on imaging studies. The case of a 45-year-old male patient is presented who after physical exertion presents dizziness, intense headache, vertigo and vomiting, the condition worsens with drowsiness and dysarthria. The results of the tomography were normal, the magnetic resonance imaging showed non-specific signs of ischemic lesions in the posterior territory. CT angiography shows occlusion of the basilar artery, distal segment. Bridging therapy with intravenous thrombolysis and mechanical thrombectomy was initiated, obtaining good results.
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Imoisili OE. Prevalence of Stroke — Behavioral Risk Factor Surveillance System, United States, 2011–2022. MMWR Morb Mortal Wkly Rep [Internet]. 2024 [citado 16 de julio de 2024];73. Disponible en: https://www.cdc.gov/mmwr/volumes/73/wr/mm7320a1.htm
Pu L, Wang L, Zhang R, Zhao T, Jiang Y, Han L. Projected Global Trends in Ischemic Stroke Incidence, Deaths and Disability-Adjusted Life Years From 2020 to 2030. Stroke. mayo de 2023;54(5):1330-9.
Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol [Internet]. octubre de 2021 [citado 16 de julio de 2024];20(10):795-820. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1474442221002520
Asensio DG. Pitfalls y variantes del tórax pediátrico. Radiología. 2016;58(2):58-69.
Hoyer C, Szabo K. Pitfalls in the Diagnosis of Posterior Circulation Stroke in the Emergency Setting. Front Neurol [Internet]. 14 de julio de 2021 [citado 16 de julio de 2024];12. Disponible en: https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.682827/full
Van der Hoeven EJRJ, Schonewille WJ, Vos JA, Algra A, Audebert HJ, Berge E, et al. The Basilar Artery International Cooperation Study (BASICS): study protocol for a randomised controlled trial. Trials. 8 de julio de 2013; 14: 200.
Salerno A, Strambo D, Nannoni S, Dunet V, Michel P. Patterns of ischemic posterior circulation strokes: A clinical, anatomical, and radiological review. Int J Stroke [Internet]. agosto de 2022 [citado 19 de julio de 2024];17(7):714-22. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9358301/
Schneider AM, Neuhaus AA, Hadley G, Balami JS, Harston GW, DeLuca GC, et al. Posterior circulation ischaemic stroke diagnosis and management. Clin Med [Internet]. 1 de mayo de 2023 [citado 16 de julio de 2024];23(3):219-27. Disponible en: https://www.sciencedirect.com/science/article/pii/S1470211824046049
Mutke MA, Potreck A, Schmitt N, Seker F, Ringleb PA, Nagel S, et al. Exact Basilar Artery Occlusion Location Indicates Stroke Etiology and Recanalization Success in Patients Eligible for Endovascular Stroke Treatment. Clin Neuroradiol [Internet]. 2023 [citado 19 de julio de 2024];33(2):483-90. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219858/
Filep RC, Marginean L, Stoian A, Bajko Z. Diagnostic and prognostic computed tomography imaging markers in basilar artery occlusion (Review). Exp Ther Med [Internet]. septiembre de 2021 [citado 19 de julio de 2024];22(3):954. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290397/
Saldaña-Inda I, Tejada-Meza H, Domínguez-Lagranja B, Barrena- Caballo MR, Sancho-Saldaña A, Serrano-Ponz M, et al. Tratamiento endovascular del ictus isquémico vertebrobasilar en Aragón: características clínicas, radiológicas, tiempos de atención y pronóstico a los 3 meses. Neurología [Internet]. 4 de agosto de 2023 [citado 7 de julio de 2024]; Disponible en: https://www.sciencedirect.com/science/article/pii/S0213485323000348
Ausman JI, Liebeskind DS, Gonzalez N, Saver J, Martin N, Villablanca JP, et al. A review of the diagnosis and management of vertebral basilar (posterior) circulation disease. Surg Neurol Int [Internet]. 24 de mayo de 2018 [citado 19 de julio de 2024]; 9: 106. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991286/
Langezaal LCM, Van Der Hoeven EJRJ, Mont’Alverne FJA, De Carvalho JJF, Lima FO, Dippel DWJ, et al. Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion. N Engl J Med [Internet]. 20 de mayo de 2021 [citado 7 de julio de 2024]; 384(20): 1910-20. Disponible en: http://www.nejm.org/doi/10.1056/NEJMoa2030297
Nie X, Wang D, Pu Y, Wei Y, Lu Q, Yan H, et al. Endovascular treatment with or without intravenous alteplase for acute ischaemic stroke due to basilar artery occlusion. Stroke Vasc Neurol [Internet]. 8 de diciembre de 2021 [citado 7 de julio de 2024];7(3):190-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9240464/
Reinemeyer N. Basilar Artery Thrombosis [Internet]. 2024. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK532241/
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