title: Extensive brainstem ischemia on neuroimaging does not preclude meaningful recovery from locked-in syndrome: two cases of endovascularly managed basilar thrombosis.
abstract: We report 2 patients with angiographically demonstrated basilar artery thrombosis who received emergent intra-arterial thrombolysis with successful recanalization of the basilar artery. In the ensuing weeks after the procedure, both patients were in a locked-in state and had sustained large bilateral regions of pontine ischemia on brain imaging. Following aggressive supportive care and rehabilitation, outcomes obtained prospectively revealed that both patients made a remarkable recovery, becoming fully independent with Barthel scores of 20 and modified Rankin scores of 2.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Nestor D
authors.initials: ND
authors.lastname: Tomycz
authors.forename: Margo B
authors.initials: MB
authors.lastname: Holm
authors.forename: Michael B
authors.initials: MB
authors.lastname: Horowitz
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Wechsler
authors.forename: Ketki
authors.initials: K
authors.lastname: Raina
authors.forename: Rishi
authors.initials: R
authors.lastname: Gupta
authors.forename: Tudor G
authors.initials: TG
authors.lastname: Jovin
mesh_terms: D000328:Adult; D001488:Basilar Artery; D002545:Brain Ischemia / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D013577:Syndrome; D014057:Tomography, X-Ray Computed