Abstract
We describe the case of a patient with a history of trigeminal neuralgia who suddenly developed the “top of the basilar” syndrome. MRI disclosed ischemic lesions in the left paramedian mesencephalic tectum, in the left ventral thalamus, in the left occipital lobe and a megadolichobasilar artery (MDBA). The association of MDBA with the top of the basilar syndrome is rarely reported. We discuss the possible hemodynamic mechanism producing a top of the basilar syndrome in the presence of MDBA.
Sommario
Viene descritto il caso di un paziente, con una storia di nevralgia trigeminale, che ha improvvisamente presentato una “top of the basilar syndrome”.
La RMN rilevava lesioni ischemiche a livello del tetto del mesencefalo in sede paramediana sinistra, nel talamo ventrale sinistro, nel lobo occipitale sinistro e la presenza di una megadolicobasilare. L'associazione di una megadolicobasilare con una “top of the basilar syndrome” è rara in letteratura. Gli autori discutono il possibile meccanismo emodinamico che può aver prodotto la sindrome in presenza di una anomala megadolicobasilare.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Acerbi G., Scassa C., Caciaglia P.:Transcranial Doppler: valori di riferimento in 70 soggetti normali. Atti della giornata su: Applicazione del Doppler transcranico in patologia vascolare cerebrale 17–28, 1986.
Barkhof F., Valk J.:“Top of the basilar syndrome”: A comparison of clinical and MR findings. Neuroradiology, 30:293–298, 1988.
Boeri R., Passerini A.:The Megadolichobasilar anomaly. J. Neurol. Sci. 1:475–484, 1964.
Bogousslavsky J., Regli F., Uske A.:Thalamic infarcts: Clinical syndromes, etiology and prognosis. Neurology 38:837–848, 1988.
Caplan L.R.:“Top of the basilar” syndrome.Neurology 30:72–79, 1980.
Casentini L., Curri D., Benedetti A., Dettori P., Bernardi L., Alexandre A.:Unusual case of dolichomegavertebrobasilar anomaly. CT and angiographic picture. Neurochirurgia 29:238–240, 1986.
Castaigne P., Lhermitte F., Buge A., Escourolle R., Hauw J.J., Lyon-Caen O.:Paramedian thalamic and midbrain infarcts: clinical and neuropathological study. Ann. Neurol. 10:127–148, 1981.
Graff-Radford N.R., Damasio H., Yamada T. Et Al:Nonhaemorrhagic thalamic infarction: Clinical, neuropsychological and electrophysiological findings in four anatomical groups defined by computerized tomography. Brain 108:485–516, 1986.
Hegedus K.:Ectasia of the Basilar Artery with special reference to possible pathogenesis. Surg. Neurol. 24:463–469, 1985.
Herpers M., Lodder J., Janevski B., Van Der Lugt P.J.M.:The symptomatology of megadolichobasilar artery. Clin. Neurol. Neurosurg. 85:203–212, 1983.
Kaplan H.A., Ford O.H.:The brain vascular system. Amsterdam: Elsevier, 1966.
Katz D.I., Alexander M.P., Mandell A.M.:Dementia following strokes in the mesencephalon and diencephalon. Arch. Neurol. 24:1127–1133, 1987.
Lazorthes G.:Vascularisation et circulation cérébrales. Paris; Masson 1961.
Maisy D.W., Cosh J.A.:Basilar artery aneurysm and Anderson-Fabry disease. J. Neurol. Neurosurg. Psychiatry 43:85–87, 1980.
Masson M., Cambier J.:Les aneurysmes vertebro-basilaires. La dolichoméga basilaire. Rev. du Prat. 2759–2769, 1967.
Miner M.E., Rea G.L., Handel S., Bertz J.:Trigeminal neuralgia due to dolichoectasia: Angiographic and CT findings in a patient with the EEC syndrome. Neuroradiology 20:163–166, 1980.
Mosely I.F., Holland I.M.:Ectasia of the basilar artery: the breadth of the clinical spectrum and the diagnostic value of computed tomography. Neuroradiology 18:83–91, 1979.
Nishizaki T., Tamaki N., Taked N., Shirakuni T., Kondoh T., Matsumoto S.:Dolichoectatic basilar artery: A review of 23 cases. Stroke 17 (6): 1277–1281, 1986.
Percheron G.:Les artères du thalamus humain.: Artères et territories thalamiques paramédians de l'artère basilaire communicante. Rev Neurol. (Paris) 132:309–324, 1976.
Petit H., Rousseaux M., Clarisse J., Delafosse A.:Troubles oculo-céphalomoteurs et infarctus thalamo-sous-thalamique bilatéral. Rev. Neurol. 137:709–722, 1981.
Sato M., Tanaka S., Kohama A.:“Top of the basilar” syndrome: Clinico-radiological evaluation. Neuroradiology, 29:354–359, 1987.
Von Cramon D.Y., Hebel N., Shuri U.:A contribution to the anatomic basis of thalamic amnesia. Brain 108:993–1008, 1985.
Yu Y., Moseley J.F., Pullicino P., McDonald W.I.:The clinical picture of ectasia of the intracerebral arteries. J. Neurol. Neurosurg. Psychiatry. 45:29–36, 1982.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Spadaro, M., Cupini, M.L., Amabile, G. et al. Association of “top of the basilar” syndrome with megadolichobasilar artery. Clinical and neuroimaging evaluation. Ital J Neuro Sci 12, 169–173 (1991). https://doi.org/10.1007/BF02337029
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02337029