RESUMO
26 patients admitted with clinical pictures consistent with meso-diencephalic infarction were studied using computerized axial tomography, magnetic resonance imaging and angiography. All of the patients presented symptoms in two of three major categories which comprise the "top of the basilar" syndrome. Lesions in the territory of the basilar-communicating artery were demonstrated in 22 of them. The remaining patients died before adequate neuroimaging documentation was obtained. Overall prognosis appeared relatively good since 80% of the patients recovered completely or incompletely from the ictus. Meso-diencephalic infarction is a very important and not uncommon subtype of cerebrovascular disorder.
Assuntos
Infarto Cerebral/patologia , Diencéfalo/patologia , Mesencéfalo/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia Cerebral , Infarto Cerebral/complicações , Infarto Cerebral/diagnóstico por imagem , Diencéfalo/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtornos Mentais/etiologia , Mesencéfalo/diagnóstico por imagem , Pessoa de Meia-Idade , Prognóstico , Síndrome , Tomografia Computadorizada por Raios X , Transtornos da Visão/etiologiaRESUMO
The term "top of the basilar" has been used in reference to a group of signs and symptoms of midbrain, diencephalic, and posteroinferior hemispheric dysfunction. It has been attributed to ischemia in the territory of second- and third-order vessels that arise from the uppermost portion of the basilar artery. We report our experience with four patients who had alteration of consciousness, confusion, and vertical gaze paresis accompanied by other physical abnormalities. Extensive evaluation did not help in documenting the lesions or in understanding their pathogenesis. The top of the basilar syndrome is a not uncommon form of stroke and carries a variable prognosis. Treatment by anticoagulation may prevent further infarction in selected patients who are seen early.
