Stent-assisted basilar reconstruction for a traumatic vertebral dissection with a large basilar artery thrombosis

J Neurointerv Surg. 2011 Mar;3(1):47-9. doi: 10.1136/jnis.2010.002410. Epub 2010 Aug 25.

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.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Athletic Injuries / diagnostic imaging
  • Athletic Injuries / drug therapy
  • Athletic Injuries / surgery*
  • Basilar Artery / diagnostic imaging
  • Basilar Artery / injuries*
  • Basilar Artery / surgery
  • Diffusion Tensor Imaging
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Intracranial Thrombosis / diagnostic imaging
  • Intracranial Thrombosis / drug therapy
  • Intracranial Thrombosis / surgery*
  • Radiography
  • Stents*
  • Thrombolytic Therapy*
  • Vertebral Artery Dissection / diagnostic imaging
  • Vertebral Artery Dissection / etiology
  • Vertebral Artery Dissection / surgery*

Substances

  • Fibrinolytic Agents