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Basilar Artery Occlusion

Basilar Artery Occlusion Abstract To the Editor. —We read with interest Fisher's description of the "herald hemiparesis" of basilar artery occlusion.1 We were reassured that his experience confirms our observations in three patients who progressed to the locked-in state after presenting with hemimotor and hemisensory symptoms accompanied by marked dysarthria.2 Indeed, as we discussed, several earlier reports of patients who developed this condition due to basilar artery occlusion described a hemiparesis and dysarthria as the presenting symptoms.3-8 In addition, this constellation of findings has been reported to be present in two thirds (10/15) of a sample of patients with brain-stem infarction whose condition subsequently worsened.9We agree that these patients may, at times, be difficult to distinguish from those with hemispheric lesions, and concur that heparin may be a useful treatment if this syndrome is recognized in a timely manner as the harbinger of a potentially grave outcome. Transcranial Doppler References 1. Fisher CM. The 'herald hemiparesis' of basilar artery occlusion . Arch Neurol . 1988;12:1301-1303.Crossref 2. Liu J, Tuhrim S, Weinberger J. Premonitory symptoms of stroke in evolution to the locked-in state . J Neurol Neurosurg Psychiatry . 1983;46:221-226.Crossref 3. Kubik CS, Adams RD. Occlusion of the basilar artery—a clinical and pathological study . Brain . 1946;69:73-121.Crossref 4. Dehaene I, Martin JJ. 'Locked-in' syndrome: a clinicopathological study of two cases . Eur Neurol . 1976;14:81-89.Crossref 5. Cravioto H, Silberman J, Feigin I. A clinical and pathological study of akinetic mutism . Neurology . 1960;10:10-21.Crossref 6. Hawkes CH. 'Locked-in' syndrome: report of seven cases . Br Med J . 1974;4:379-382.Crossref 7. Fang HC, Palmer JJ. Vascular phenomena involving brainstem structures . Neurology . 1956:6:402-419.Crossref 8. Nordgren RE, Markesby WR, Fukadi K, Reeves AG. Seven cases of cerebromedullospinal disconnection: the 'locked-in' syndrome . Neurology . 1971:21:1140-1148.Crossref 9. Tuhrim S, Banks M, Price TR. A syndrome which predicts worsening in brainstem infarction . Neurology . 1984;34( (suppl 1) ):165. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Basilar Artery Occlusion

Abstract

Abstract To the Editor. —We read with interest Fisher's description of the "herald hemiparesis" of basilar artery occlusion.1 We were reassured that his experience confirms our observations in three patients who progressed to the locked-in state after presenting with hemimotor and hemisensory symptoms accompanied by marked dysarthria.2 Indeed, as we discussed, several earlier reports of patients who developed this condition due to basilar artery occlusion described a...
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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1989.00520450016007
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —We read with interest Fisher's description of the "herald hemiparesis" of basilar artery occlusion.1 We were reassured that his experience confirms our observations in three patients who progressed to the locked-in state after presenting with hemimotor and hemisensory symptoms accompanied by marked dysarthria.2 Indeed, as we discussed, several earlier reports of patients who developed this condition due to basilar artery occlusion described a hemiparesis and dysarthria as the presenting symptoms.3-8 In addition, this constellation of findings has been reported to be present in two thirds (10/15) of a sample of patients with brain-stem infarction whose condition subsequently worsened.9We agree that these patients may, at times, be difficult to distinguish from those with hemispheric lesions, and concur that heparin may be a useful treatment if this syndrome is recognized in a timely manner as the harbinger of a potentially grave outcome. Transcranial Doppler References 1. Fisher CM. The 'herald hemiparesis' of basilar artery occlusion . Arch Neurol . 1988;12:1301-1303.Crossref 2. Liu J, Tuhrim S, Weinberger J. Premonitory symptoms of stroke in evolution to the locked-in state . J Neurol Neurosurg Psychiatry . 1983;46:221-226.Crossref 3. Kubik CS, Adams RD. Occlusion of the basilar artery—a clinical and pathological study . Brain . 1946;69:73-121.Crossref 4. Dehaene I, Martin JJ. 'Locked-in' syndrome: a clinicopathological study of two cases . Eur Neurol . 1976;14:81-89.Crossref 5. Cravioto H, Silberman J, Feigin I. A clinical and pathological study of akinetic mutism . Neurology . 1960;10:10-21.Crossref 6. Hawkes CH. 'Locked-in' syndrome: report of seven cases . Br Med J . 1974;4:379-382.Crossref 7. Fang HC, Palmer JJ. Vascular phenomena involving brainstem structures . Neurology . 1956:6:402-419.Crossref 8. Nordgren RE, Markesby WR, Fukadi K, Reeves AG. Seven cases of cerebromedullospinal disconnection: the 'locked-in' syndrome . Neurology . 1971:21:1140-1148.Crossref 9. Tuhrim S, Banks M, Price TR. A syndrome which predicts worsening in brainstem infarction . Neurology . 1984;34( (suppl 1) ):165.

Journal

Archives of NeurologyAmerican Medical Association

Published: Sep 1, 1989

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