title: Stent-assisted basilar reconstruction for a traumatic vertebral dissection with a large basilar artery thrombosis.
abstract: An individual in their 30s presented with quadriplegia and coma 7 h after a 30-foot free-fall. Angiography confirmed left vertebral artery dissection causing vertebral artery occlusion (thrombolysis in myocardial infarction (TIMI) 0) and basilar artery thrombosis. Deployment of six self-expanding intracranial stents (right P1 to left V3) resulted in recanalization (TIMI 3). Postoperative MRI demonstrated a large brainstem infarction; the patient was 'locked-in'. In the following 6 months, the patient recovered to ambulation and independence. Aggressive recanalization for symptomatic vertebrobasilar dissection/occlusion may be considered. Despite major diffusion-weighted imaging brainstem lesions, recovery is possible.
authors: Department of Neurosurgery, Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA. elevy@ubns.com
authors: Erik F
authors: EF
authors: Hauck
authors: Sabareesh K
authors: SK
authors: Natarajan
authors: Dennis B
authors: DB
authors: Horvathy
authors: L Nelson
authors: LN
authors: Hopkins
authors: Adnan H
authors: AH
authors: Siddiqui
authors: Elad I
authors: EI
authors: Levy
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D056324:Diffusion Tensor Imaging; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D011859:Radiography; D015607:Stents; D015912:Thrombolytic Therapy; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*
chemical_list: D005343:Fibrinolytic Agents