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Unusual presentation of basilar artery thrombosis

Strokes in the territory of the posterior cerebral artery (PCA) may rarely cause acute confusion or delirium, especially when bilateral or the dominant PCA are involved. Delirium as the only initial presentation of basilar artery thrombosis (with no brainstem or long tract findings) is an extremely...

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Autores principales: Algahtani, Hussein, Shirah, Bader, Abdelghaffar, Nawal, Alqahtani, Abdulrahman J., Alshehri, Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820268/
https://www.ncbi.nlm.nih.gov/pubmed/33272006
http://dx.doi.org/10.7461/jcen.2020.E2020.04.001
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author Algahtani, Hussein
Shirah, Bader
Abdelghaffar, Nawal
Alqahtani, Abdulrahman J.
Alshehri, Mohammad
author_facet Algahtani, Hussein
Shirah, Bader
Abdelghaffar, Nawal
Alqahtani, Abdulrahman J.
Alshehri, Mohammad
author_sort Algahtani, Hussein
collection PubMed
description Strokes in the territory of the posterior cerebral artery (PCA) may rarely cause acute confusion or delirium, especially when bilateral or the dominant PCA are involved. Delirium as the only initial presentation of basilar artery thrombosis (with no brainstem or long tract findings) is an extremely rare occurrence. In this article, the clinical presentation of our case was an acute confusion with septic shock-like features (tachycardia, hypotension, and leukocytosis) for a few days without any focal deficit. These symptoms pointed more toward a non-focal neurological cause, especially meningoencephalitis. This case highlights the importance of detailed history and thorough evaluation of high-risk patients who present with an acute devastating neurological syndrome. In addition, knowledge of the atypical presentation of stroke should be acquired, and the limitation of an unenhanced computed tomography scan of the brain without vascular imaging should be known. Investigating patients with a sudden acute confusion should be directed toward the evaluation of the etiology in a stepwise manner. However, the pace of investigations should be fast to establish the diagnosis and optimize the outcome.
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spelling pubmed-78202682021-01-27 Unusual presentation of basilar artery thrombosis Algahtani, Hussein Shirah, Bader Abdelghaffar, Nawal Alqahtani, Abdulrahman J. Alshehri, Mohammad J Cerebrovasc Endovasc Neurosurg Case Report Strokes in the territory of the posterior cerebral artery (PCA) may rarely cause acute confusion or delirium, especially when bilateral or the dominant PCA are involved. Delirium as the only initial presentation of basilar artery thrombosis (with no brainstem or long tract findings) is an extremely rare occurrence. In this article, the clinical presentation of our case was an acute confusion with septic shock-like features (tachycardia, hypotension, and leukocytosis) for a few days without any focal deficit. These symptoms pointed more toward a non-focal neurological cause, especially meningoencephalitis. This case highlights the importance of detailed history and thorough evaluation of high-risk patients who present with an acute devastating neurological syndrome. In addition, knowledge of the atypical presentation of stroke should be acquired, and the limitation of an unenhanced computed tomography scan of the brain without vascular imaging should be known. Investigating patients with a sudden acute confusion should be directed toward the evaluation of the etiology in a stepwise manner. However, the pace of investigations should be fast to establish the diagnosis and optimize the outcome. Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2020-12 2020-12-04 /pmc/articles/PMC7820268/ /pubmed/33272006 http://dx.doi.org/10.7461/jcen.2020.E2020.04.001 Text en Copyright © 2020 by KSCVS and KoNES This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Algahtani, Hussein
Shirah, Bader
Abdelghaffar, Nawal
Alqahtani, Abdulrahman J.
Alshehri, Mohammad
Unusual presentation of basilar artery thrombosis
title Unusual presentation of basilar artery thrombosis
title_full Unusual presentation of basilar artery thrombosis
title_fullStr Unusual presentation of basilar artery thrombosis
title_full_unstemmed Unusual presentation of basilar artery thrombosis
title_short Unusual presentation of basilar artery thrombosis
title_sort unusual presentation of basilar artery thrombosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820268/
https://www.ncbi.nlm.nih.gov/pubmed/33272006
http://dx.doi.org/10.7461/jcen.2020.E2020.04.001
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