Basilar artery narrowing and hyperparathyroidism: illustrative case.

Area of Science:

• Neurology
• Endocrinology
• Vascular Medicine

Background:

• Hyperparathyroidism is a condition characterized by excessive parathyroid hormone production.
• Elevated serum calcium levels (hypercalcemia) are a hallmark of hyperparathyroidism.
• Cerebral artery narrowing can lead to ischemic stroke.

Observation:

• A patient presented with a pontine infarction, a type of stroke affecting the brainstem.
• The infarction was associated with narrowing of the mid-basilar artery.
• The patient had a history of hyperparathyroidism due to a parathyroid adenoma.

Findings:

• Surgical removal of the parathyroid adenoma led to the normalization of serum calcium levels.
• The mid-basilar artery narrowing reversed following the normalization of calcium.
• The patient's neurological condition improved after the intervention.

Implications:

• This case suggests a direct link between hyperparathyroidism-induced hypercalcemia and cerebral vasoconstriction.
• The findings support the role of calcium in regulating cerebral blood flow and preventing stroke.
• Management of hyperparathyroidism may be crucial in patients with unexplained cerebral artery stenosis.