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Vascular pattern and radiological follow up in a case of pontine warning syndrome

Pontine warning syndrome (PWS) is a condition characterized by crescendo transient ischemic attacks due to pontine ischemia. The reported case described a 72-year-old woman who presented repetitive sudden episodes of double vision, impaired balance, slurred speech and right-sided weakness. Neurologi...

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Detalles Bibliográficos
Autores principales: Currò, Carmelo Tiberio, Francalanza, Isabella, Cotroneo, Masina, Dell’Aera, Cristina, Casella, Carmela, La Spina, Paolino, Fazio, Maria Carolina, Grillo, Francesco, Toscano, Antonio, Musolino, Rosa Fortunata
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242993/
https://www.ncbi.nlm.nih.gov/pubmed/34222700
http://dx.doi.org/10.1016/j.heliyon.2021.e07369
Descripción
Sumario:Pontine warning syndrome (PWS) is a condition characterized by crescendo transient ischemic attacks due to pontine ischemia. The reported case described a 72-year-old woman who presented repetitive sudden episodes of double vision, impaired balance, slurred speech and right-sided weakness. Neurological deficits lasted a few minutes-hours and disappeared during the first seven days after onset. On the 1st day, MRI revealed acute left paramedian pontine infarction with focal swelling. Supra-aortic vessel imagining revealed bilateral internal carotid stenosis of 50%; hypoplasia of the left vertebral artery. On the 7th day, MRI showed a tissue swelling reduction, and from that day, she had no symptoms. These clinical and radiological features were suggestive of PWS. Our patient presented a particular vascular pattern that could favour symptoms fluctuation. We performed a close MRI follow up and it allowed us to observe a clinical stabilization in association with edema reduction.