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World Journal of Clinical Cases 2019年第1期7卷 73-78页

作者： Xuan-Ting Li Jun-Liang Yuan Wen-Li Hu Department of Neurology Beijing Chaoyang Hospital Capital Medical University

BACKGROUND Millard-Gubler syndrome(MGS) is caused by a lesion in the brainstem at the level of the facial nerve nucleus, and it is also a rare ventral pontine syndrome.vertebrobasilar artery dissection(VAD) is an uncommon cause of ischemic stroke. To the best of our knowledge, this is the first case report on the coexistence of MGS and VAD in a young acute ischemic stroke patient.CASE SUMMARY We herein describe an unusual case of young acute ischemic stroke patient,presenting with acute right peripheral facial palsy, right abducens palsy, and contralateral hemihypesthesia, manifesting as MGS. After receiving dual antiplatelet therapy with aspirin and clopidogrel, as well as rosuvastatin, the patient recovered significantly. The high-resolution magnetic resonance imaging(MRI) indicated a diagnosis of VAD.CONCLUSION Our finding further demonstrated that high-resolution MRI is a useful technique to early detect underlying dissection in posterior circulation ischemic stroke.

关键词： Millard-Gubler syndrome vertebrobasilar artery dissection Ischemic stroke Case report

Endovascular revascularisation of acute tandem vertebrobasilar artery occlusion:seven case series with literature reviews

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Stroke & Vascular Neurology 2018年第1期3卷 17-21页

作者： Haihua Yang Ning Ma Shiyong Zhang Xiaochuan Huo Feng Gao Xuan Sun Dapeng Mo Zhongrong Miao Department of Interventional Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Neurology Beijing Daxing HospitalCapital Medical UniversityBeijingChina Department of Interventional Neurology Beijing Fengtai Youanmen HospitalBeijingChina

background The outcome of acute ischaemic stroke due to tandem vertebrobasilar artery occlusion was poor.Endovascular revascularisation may be a positive approach for acute basilar artery occlusion combined with vertebral ostium stenosis or occlusion.We reported seven patients with acute vertebrobasilar tandem occlusion by using angioplasty or stenting for proximal lesion and thrombectomy for distal occlusion.Materials and methods Consecutive patients with acute tandem vertebrobasilar artery occlusion at two centres were included in this study.We retrospectively analysed the clinical,technical and functional outcomes of the patients.results From March 2016 to March 2017,seven patients were included.The mean age and National Institute of Health Stroke Scale score at admission was 57 years and 22,respectively.A reverse approach was used in five patients.The Thrombolysis in Cerebral Infarction score 2b-3 was acquired in all patients.There were no procedural complications.The modified Rankin Scale score was 1-2 for three patients and 4 for one patient at 3 months.Three patients died at 3 months of follow-up.Conclusions Endovascular revascularisation may be feasible for acute tandem vertebrobasilar artery occlusion,and more researches are needed.

关键词： occlusion acute vertebrobasilar

Glossopharyngeal Neuralgia Due to vertebrobasilar Dolichoectasia Coexisting with Fusiform Aneurysm of the Basilar Artery

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Case Reports in Clinical Medicine 2014年第10期3卷 545-548页

作者： Jianguo Zhong Zhengyu Dai Fei Chen Gendi Wang Haicun Shi Weigeng Song Congsong Dong Department of Neurology The Affiliated Yancheng Hospital of Southeast University Medical College Yancheng China Department of Radiology The Affiliated Yancheng Hospital of Southeast University Medical College Yancheng China

Glossopharyngeal neuralgia (GPN) refers to paroxysmal severe pain located to glossopharyngeal part or ear, which is a rare clinical event. In this report, we describe a patient suffered from glossopharyngeal neuralgia due to vertebrobasilar dolichoectasia (VBD). A 72-year-old Chinese male was referred to our clinic with a complaint of paroxysmal severe pain in the right external auditory canal and auricle since 1 month, which could be precipitated by feed and accompanied with the vagus nerve irritation (bradycardia, low blood pressure, syncope) sometimes. Both computed tomographic angiography and digital subtraction angiography demonstrated a VBD (maximum diameter 5.7 mm) and a large fusiform aneurysm of basilar artery (maximum diameter 13.8 mm). The diagnosis is established on clinical and radiological signs. This is the first report of this kind in the literature. Although a few cases demonstrate that VBD can cause GPN, it should be considered as a possible etiology in patients with GPN.

关键词： Glossopharyngeal Neuralgia vertebrobasilar Dolichoectasia Computed Tomographic Angiography Digital Subtraction Angiography

Evaluation value of CTA for vertebrobasilar artery stenosis in patients with posterior circulation cerebral infarction and its correlation with serum biochemical indexes

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Journal of Hainan Medical University 2017年第23期23卷 136-139页

作者： De-Ming Tian Yu-Sheng Zhu Feng-Chun Zhou Yang Zhang Intervention Department Maanshan Shiqiye Hospital in Anhui ProvinceMaanshan CityAnhui Province243000

Objective: To study the evaluation value of CTA for vertebrobasilar artery stenosis in patients with posterior circulation cerebral infarction and its correlation with serum biochemical indexes. Methods: A total of 148 patients who were treated in Maanshan Shiqiye Hospital between June 2014 and February 2017 due to vertebrobasilar artery stenosis were selected as the research subjects and divided into cerebral infarction group and transient ischemic attack (TIA) group according to the imageological examination. CTA was used to evaluate vertebrobasilar atherosclerotic plaque properties, and enzyme-linked immunosorbent assay kit was used to determine the levels of nerve injury markers, inflammatory response-related molecules and plaque property-related protease molecules. Results: The positive rate of posterior circulation plaque in cerebral infarction group was obviously higher than that in TIA group, and the positive rate of unstable plaque, fibrous plaque and calcified plaque were higher than those in TIA group;serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque, fibrous plaque and calcified plaque were all higher than those of TIA group;serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque and fibrous plaque were all higher than those of patients with calcified plaque, and serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque were all higher than those of patients with fibrous plaque. Conclusion: CTA can accurately assess the property of vertebrobasilar atherosclerotic plaque in patients with posterior circulation cerebral infarction and is closely related to the degree of nerve injury and the change of plaque property.

关键词： Posterior circulation cerebral infarction CT angiography vertebrobasilar artery stenosis Atherosclerosis

Decompressive Craniectomy in Posterior Fossa Ischemic Stroke

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International Journal of Clinical Medicine 2012年第4期3卷 302-303页

作者： Luciano Santana-Cabrera Guillermo Pérez-Acosta Cristina Rodríguez-Escot Rosa Lorenzo-Torrent Manuel Sánchez-Palacios Intensive Care Unit Insular Universitary Hospital of Gran Canaria Las Palmas of Gran Canaria Spain. South maritime avenue n/n. Las Palmas of Gran Canaria. Canary Islands. Spain. Postal Code: 35016 Intensive Care Unit Insular Universitary Hospital of Gran Canaria Las Palmas of Gran Canaria Spain. South maritime avenue n/n. Las Palmas of Gran Canaria. Canary Islands. Spain. Postal Code: 35016. Intensive Care Unit Insular Universitary Hospital of Gran Canaria Las Palmas of Gran Canaria Spain. South maritime avenue n/n.Las Palmas of Gran Canaria. Canary Islands. Spain. Postal Code: 35016

Ischemic damage produced in the posterior cerebral territory causes significant morbidity and urgently must be considered if the patient need a surgical attitude. Surgical decompression by suboccipital craniectomy seams to be effective to treat secondary edema due to cerebellar damage or in posterior fossa, when medical treatment is not able to control side effects. We report a clinical case of a patient with a subacute ischemic infarction in the vertebro-basilar territory, with perilesional edema, and a posterior fossa decompressive craniectomy (DC) was carried out.

关键词： Decompressive Craniectomy Posterior Fossa Suboccipital Craniectomy vertebrobasilar Insufficiency