Locked-in syndrome from rostro-caudal herniation.
Locked-in syndrome (LIS) is often caused by ventral pontine injury involving the perforating pontine vessels of the basilar artery and recovery is rarely reported. We report a patient who developed LIS acutely after aneurysmal subarachnoid haemorrhage and rostro-caudal herniation from hydrocephalus. The patient's clinical course and diagnostic studies suggest that the likely mechanism of this patient's LIS is mechanical compression of the ventral pons anteriorly against the clivus. The patient's slow but full recovery allowed us to further differentiate this clinical entity from the more common LIS due to ischaemic mechanisms.
Luxenberg
Erin L
EL
Neurocritical Care and Acute Stroke Section, Departments of Neurology and Surgery (Neurosurgery), University of Chicago Medical Center, 5841 South Maryland Avenue MC 2030, Chicago, Illinois 60637, USA.
Goldenberg
Fernando D
FD
Frank
Jeffrey I
JI
Loch Macdonald
R
R
Rosengart
Axel J
AJ
D003072:Cognition Disorders / Q000150:complications / Q000209:etiology; D003388:Cranial Fossa, Posterior / Q000098:blood supply / Q000473:pathology; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D006547:Hernia / Q000150:complications / Q000209:etiology / Q000473:pathology; D006801:Humans; D006849:Hydrocephalus / Q000150:complications; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011149:Pons / Q000098:blood supply / Q000473:pathology; D011782:Quadriplegia / Q000209:etiology*; D013345:Subarachnoid Hemorrhage / Q000150:complications; D014057:Tomography, X-Ray Computed