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Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
Chronic basilar artery occlusion: a retrospective monocentric study
Christian Roth1,2, Rosa Yavuz3, Carolin Maschita3
1Departement of Neurology, Klinikum Kassel, Mönchebergstraße 41-43, 34125, Kassel, Germany. roth99@web.de.
Insights
Chronic basilar artery occlusion (CBAO) can be asymptomatic or present with mild symptoms, and patients can survive long-term. Arteriosclerosis is a likely cause, indicated by prevalent vascular risk factors.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Background:
- Acute basilar artery occlusion is a critical condition with high mortality.
- Clinical presentation and progression of chronic basilar artery occlusion (CBAO) are poorly understood.
- This study aimed to analyze the clinical characteristics of patients with CBAO.
Purpose of the Study:
- To systematically analyze the clinical presentation of patients diagnosed with chronic basilar artery occlusion (CBAO).
Main Methods:
- Retrospective analysis of adult patients with CBAO treated between 2015 and 2023.
- Inclusion criteria: basilar artery occlusion without brainstem infarction or unrevascularized occlusion with >3 months follow-up.
Main Results:
- Fifteen patients with CBAO were identified.
- Presentations varied: incidental finding (5), mild neurological symptoms (4), or acute occlusion with follow-up (6).
- Midbasilar occlusion was most common (80%); posterior communicating artery collateralization was universal. Hypertension (100%) and hypercholesterolemia (67%) were prevalent vascular risk factors.
Conclusions:
- Chronic basilar artery occlusion (CBAO) can be asymptomatic or mildly symptomatic and compatible with long-term survival.
- High prevalence of vascular risk factors suggests arteriosclerosis as a primary cause.
- Further research into CBAO management and long-term outcomes is warranted.
Background:
Acute basilar artery occlusion is a life-threatening medical emergency with a highly elevated mortality rate when left untreated. Little is known about symptoms and clinical progression of chronic occlusions. The aim of this study was to systematically analyze the clinical presentation of patients with chronic basilar artery occlusion (CBAO).
Methods:
Monocentric retrospective analysis of adult patients with CBAO was treated between 2015 and 2023 in the Department of Neurology, Klinikum Kassel. Inclusion criteria were basilar artery occlusion without brainstem infarction as well as patients with a basilar artery occlusion in whom revascularization could not be achieved and a follow-up period of at least 3 months.
Results:
A total of 15 patients were found. In five patients basilar artery occlusion was diagnosed as an incidental finding, four patients had neurological symptoms but no proven brainstem infarction (3 × transient ischemic attack, 1 × isolated posterior artery infarct) and six patients presented with acute basilar artery occlusion and a follow-up > 3 months. The most common site of occlusion was midbasilar (80%, n = 12), isolated (n = 7) or in combination with other locations (n = 5). In all cases collateralization could be demonstrated by the posterior communicating arteries. The most common vascular risk factors (VRF) were hypertension (100%) and hypercholesterolemia (67%).
Conclusions:
Patients with CBAO may present with only mild symptoms or may even be asymptomatic. This condition may be survived for a long time. The high percentage of vascular risk factors and further cerebral vessel occlusions suggest arteriosclerosis as the major causing factor of CBAO.
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