Extensive brainstem ischemia on neuroimaging does not preclude meaningful recovery from locked-in syndrome: two cases of endovascularly managed basilar thrombosis.
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.
Tomycz
Nestor D
ND
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Holm
Margo B
MB
Horowitz
Michael B
MB
Wechsler
Lawrence R
LR
Raina
Ketki
K
Gupta
Rishi
R
Jovin
Tudor G
TG
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