Brain Stem Infarction Due to Basilar Artery Dissection in a Patient with a Parotitis and Hyperhomocysteinemia

A 29-year-old man developed sudden dysarthria and right-sided weakness 3 days before admission to hospital. He was diagnosed with parotitis in the emergency room of Soonchunhyang University Gumi Hospital. The plasma levels of homocysteine were elevated (30.48 mg/dL). A brain magnetic resonance imaging scan revealed a high signal intensity lesion in the left paramedian pons and computed tomography angiography showed a marked narrowing of the mid-basilar artery. We report a rare case of spontaneous basilar artery dissection caused by a recent infection and hyperhomocysteinemia.

Acute Pontine Infarction due to Basilar Artery Dissection from Strenuous Physical Effort: One from Sexual Intercourse and Another from Defecation

A basilar artery dissection (BAD) is an extremely rare disease. It can lead to hemorrhage or infarction involving the brain stem, and is often associated with grave outcome. However, little is known about the pathophysiology of BAD, and its proper managements are yet in controversy. Herein, we report on two rare cases of basilar artery dissection from strenuous physical effort; one from sexual intercourse and another from defecation. The treatment modalities and the outcomes are also discussed.

Acute Pontine Infarction due to Basilar Artery Dissection from Strenuous Physical Effort: One from Sexual Intercourse and Another from Defecation

A basilar artery dissection (BAD) is an extremely rare disease. It can lead to hemorrhage or infarction involving the brain stem, and is often associated with grave outcome. However, little is known about the pathophysiology of BAD, and its proper managements are yet in controversy. Herein, we report on two rare cases of basilar artery dissection from strenuous physical effort; one from sexual intercourse and another from defecation. The treatment modalities and the outcomes are also discussed.

Endovascular treatment of a basilar artery dissecting aneurysm

Basilar artery (BA) dissecting aneurysms pose difficulties to treatment because both bleeding and thrombosis can happen in the same patient, clinical course is unpredictable and high morbidity is usual. We report the case of a 37-year-old woman with a BA aneurysm probably caused by arterial dissection, presenting embolic and hemorrhagic complications. The aneurysm was submitted to endovascular treatment with stenting and coil embolization. Clinical and radiological results were excellent and no complications were observed, suggesting that BA stenting and coil embolization may be a safe and effective treatment for this condition.

Aneurismas associados a dissecção da artéria basilar (AB) apresentam dificuldades terapêuticas, pois sangramentos e fenômenos trombóticos podem ocorrer no mesmo paciente, seu curso clínico é imprevisível e sua morbidade, alta. Relatamos o caso de uma paciente de 37 anos com aneurisma de artéria basilar provavelmente causado por dissecção arterial, apresentando-se com complicações hemorrágicas e embólicas. O aneurisma foi submetido a tratamento endovascular com colocação de "stent" e embolização com molas. Os resultados clínico e radiológico foram excelentes e nenhuma complicação foi observada, sugerindo que o tratamento dos aneurismas de AB dissecantes com colocação de "stent" e embolização com molas possa ser seguro e eficaz.