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[Mesencephalic artery syndrome]

A Jedrzejewska-Iwanowska, M Dowgiallo

    Neurologia I Neurochirurgia Polska
    |July 1, 1977
    PubMed
    Summary

    A basilar artery thrombosis caused stroke-like symptoms and symmetrical thalamic necrosis in a 62-year-old woman. Autopsy revealed thrombosis at the basilar artery bifurcation, leading to characteristic "butterfly type" thalamic and midline brainstem necrosis.

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    Area of Science:

    • Neurology
    • Pathology
    • Vascular Medicine

    Background:

    • Stroke is a leading cause of disability and death, often resulting from vascular occlusions.
    • Basilar artery thrombosis is a rare but devastating cause of ischemic stroke, affecting critical brainstem and thalamic structures.
    • Understanding the specific pathological patterns associated with basilar artery thrombosis is crucial for diagnosis and treatment.

    Observation:

    • A 62-year-old woman presented with acute neurological deficits mimicking a stroke.
    • Clinical manifestations included sudden unconsciousness, left oculomotor nerve palsy, and right-sided hemiparesis with an extensor plantar response.
    • These symptoms indicated severe damage to the central nervous system.

    Findings:

    • Autopsy examination revealed thrombosis at the bifurcation of the basilar artery.
    • Symmetrical "butterfly type" necrosis of the thalamus was observed.
    • Necrosis of the midline mesencephalic and pontine structures was also identified, consistent with the vascular occlusion.

    Implications:

    • This case highlights the critical role of the basilar artery in supplying vital brain structures.
    • "Butterfly type" thalamic necrosis is a specific neuropathological finding associated with basilar artery occlusion.
    • Accurate diagnosis and timely intervention in basilar artery thrombosis are essential to prevent catastrophic neurological outcomes.

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