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 unco...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.展开更多
Insufficient blood supply to vertebrobasilarartery is one of the ischemic cerebrovascular diseasesencountered commonly and frequently in old people.Its clinical symptoms are capricious,and severeischemia may jeopardiz...Insufficient blood supply to vertebrobasilarartery is one of the ischemic cerebrovascular diseasesencountered commonly and frequently in old people.Its clinical symptoms are capricious,and severeischemia may jeopardize the life of the patient.Thekey point for saving the patient's life and raising thequality of life is to relieve the symptoms and improveblood supply to the brain.From May 1995 to展开更多
Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular...Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular fenestrations after the anterior communicating artery. Vertebrobasilar junction aneurysms are uncommon but often associated with basilar artery fenestration. We report the case of a fenestrated vertebrobasilar junction saccular aneurysm in a 57-year-old woman. The diagnosis was incidentally made on CT angiography which found the anatomical variant and the aneurysm. The radiological features illustrating this association are detailed here and a brief discussion of its pathogenesis and management was made. Vertebrobasilar junction aneurysms are rare and their presence should suggest an associated basilar fenestration.展开更多
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...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.展开更多
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 14...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.展开更多
基金Supported by the National Natural Science Foundation of China,No.81301016the Beijing Municipal Administration of Hospitals’ Youth Programme,No.QML20150303
文摘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.
文摘Insufficient blood supply to vertebrobasilarartery is one of the ischemic cerebrovascular diseasesencountered commonly and frequently in old people.Its clinical symptoms are capricious,and severeischemia may jeopardize the life of the patient.Thekey point for saving the patient's life and raising thequality of life is to relieve the symptoms and improveblood supply to the brain.From May 1995 to
文摘Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular fenestrations after the anterior communicating artery. Vertebrobasilar junction aneurysms are uncommon but often associated with basilar artery fenestration. We report the case of a fenestrated vertebrobasilar junction saccular aneurysm in a 57-year-old woman. The diagnosis was incidentally made on CT angiography which found the anatomical variant and the aneurysm. The radiological features illustrating this association are detailed here and a brief discussion of its pathogenesis and management was made. Vertebrobasilar junction aneurysms are rare and their presence should suggest an associated basilar fenestration.
文摘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.
基金Natural Science Foundation of Anhui Province No:1308085MH158.
文摘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.
