Abstract：
BACKGROUND: Acute basilar artery occlusion is a life-threatening medical emergency with a highly elevated mortality rate when left untreated. Little is known about symptoms and clinical progression of chronic occlusions. The aim of this study was to systematically analyze the clinical presentation of patients with chronic basilar artery occlusion (CBAO).
METHODS: Monocentric retrospective analysis of adult patients with CBAO was treated between 2015 and 2023 in the Department of Neurology, Klinikum Kassel. Inclusion criteria were basilar artery occlusion without brainstem infarction as well as patients with a basilar artery occlusion in whom revascularization could not be achieved and a follow-up period of at least 3 months.
RESULTS: A total of 15 patients were found. In five patients basilar artery occlusion was diagnosed as an incidental finding, four patients had neurological symptoms but no proven brainstem infarction (3 × transient ischemic attack, 1 × isolated posterior artery infarct) and six patients presented with acute basilar artery occlusion and a follow-up > 3 months. The most common site of occlusion was midbasilar (80%, n = 12), isolated (n = 7) or in combination with other locations (n = 5). In all cases collateralization could be demonstrated by the posterior communicating arteries. The most common vascular risk factors (VRF) were hypertension (100%) and hypercholesterolemia (67%).
CONCLUSIONS: Patients with CBAO may present with only mild symptoms or may even be asymptomatic. This condition may be survived for a long time. The high percentage of vascular risk factors and further cerebral vessel occlusions suggest arteriosclerosis as the major causing factor of CBAO.
METHODS: Monocentric retrospective analysis of adult patients with CBAO was treated between 2015 and 2023 in the Department of Neurology, Klinikum Kassel. Inclusion criteria were basilar artery occlusion without brainstem infarction as well as patients with a basilar artery occlusion in whom revascularization could not be achieved and a follow-up period of at least 3 months.
RESULTS: A total of 15 patients were found. In five patients basilar artery occlusion was diagnosed as an incidental finding, four patients had neurological symptoms but no proven brainstem infarction (3 × transient ischemic attack, 1 × isolated posterior artery infarct) and six patients presented with acute basilar artery occlusion and a follow-up > 3 months. The most common site of occlusion was midbasilar (80%, n = 12), isolated (n = 7) or in combination with other locations (n = 5). In all cases collateralization could be demonstrated by the posterior communicating arteries. The most common vascular risk factors (VRF) were hypertension (100%) and hypercholesterolemia (67%).
CONCLUSIONS: Patients with CBAO may present with only mild symptoms or may even be asymptomatic. This condition may be survived for a long time. The high percentage of vascular risk factors and further cerebral vessel occlusions suggest arteriosclerosis as the major causing factor of CBAO.
摘要：
背景：急性基底动脉闭塞是一种危及生命的医疗紧急情况，如果不治疗，死亡率会很高。对慢性闭塞的症状和临床进展知之甚少。本研究旨在系统分析慢性基底动脉闭塞(CBAO)患者的临床表现。
方法：单中心回顾性分析2015年至2023年在神经内科治疗的成人CBAO患者，KlinikumKassel.纳入标准为无脑干梗死的基底动脉闭塞患者以及无法实现血运重建的基底动脉闭塞患者，随访期至少3个月。
结果：共发现15例患者。在五名患者中，基底动脉闭塞被诊断为偶然发现，四名患者有神经系统症状，但没有证实脑干梗死（3×短暂性脑缺血发作，1倍孤立的后动脉梗塞）和6例患者出现急性基底动脉闭塞，随访时间>3个月。最常见的闭塞部位是中基底动脉(80%，n=12),隔离（n=7）或与其他位置组合（n=5）。在所有情况下，后交通动脉都可以证明侧支。最常见的血管危险因素（VRF）是高血压（100％）和高胆固醇血症（67％）。
结论：CBAO患者可能仅有轻度症状，甚至可能无症状。这种情况可能会存活很长时间。高比例的血管危险因素和进一步的脑血管闭塞提示动脉硬化是CBAO的主要原因。
方法：单中心回顾性分析2015年至2023年在神经内科治疗的成人CBAO患者，KlinikumKassel.纳入标准为无脑干梗死的基底动脉闭塞患者以及无法实现血运重建的基底动脉闭塞患者，随访期至少3个月。
结果：共发现15例患者。在五名患者中，基底动脉闭塞被诊断为偶然发现，四名患者有神经系统症状，但没有证实脑干梗死（3×短暂性脑缺血发作，1倍孤立的后动脉梗塞）和6例患者出现急性基底动脉闭塞，随访时间>3个月。最常见的闭塞部位是中基底动脉(80%，n=12),隔离（n=7）或与其他位置组合（n=5）。在所有情况下，后交通动脉都可以证明侧支。最常见的血管危险因素（VRF）是高血压（100％）和高胆固醇血症（67％）。
结论：CBAO患者可能仅有轻度症状，甚至可能无症状。这种情况可能会存活很长时间。高比例的血管危险因素和进一步的脑血管闭塞提示动脉硬化是CBAO的主要原因。
