Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report

Twenty percent of strokes occurring in young patients are represented by posterior ischemic strokes. Acute basilar occlusion is a devastating, life-threatening condition, with the highest mortality in young patients. We present the case of a 33-year-old female patient, without vascular risk factors...

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Main Authors: Maria-Gabriela Catană, Corina Roman-Filip
Format: Article
Language:English
Published: Romanian Association of Balneology, Editura Balneara 2019-02-01
Series:Balneo Research Journal
Subjects:
Online Access:http://bioclima.ro/Balneo231.pdf
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spelling doaj-9650c4037d864eabb9c953a119283bd22020-11-24T23:57:18ZengRomanian Association of Balneology, Editura BalnearaBalneo Research Journal2069-75972069-76192019-02-01101081110.12680/balneo.2019.231Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case reportMaria-Gabriela Catană0Corina Roman-Filip1 Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaTwenty percent of strokes occurring in young patients are represented by posterior ischemic strokes. Acute basilar occlusion is a devastating, life-threatening condition, with the highest mortality in young patients. We present the case of a 33-year-old female patient, without vascular risk factors or oral contraceptive treatment, admitted to our department through the emergency ward for comatose state – Glasgow Coma Scale (GCS) 11 points, headaches, right-sided hemiparesis, dizziness and vomiting, with acute onset. CT angiography was performed, which showed left vertebral artery with no flow in the intradural section and absent flow in the basilar artery. After more than 12 hours from onset, endarterectomy was excluded; initiation of treatment with heparin 1000 IU/hour was decided. MRI performed after 24 hours revealed: subacute median and left paramedian pontine ischemic stroke, subacute stroke in the base of the left midbrain peduncle. The following diagnosis was established: pontine ischemic stroke caused by two autoimmune diseases: thrombophilia and antiphospholipid antibody syndrome. Our patient started rehabilitation very early and was discharged with the following neurological sequelae: tetraparesis with the predominance of left hemiparesis: 4/5 on the Medical Research Council strength scale (MRC) – right limbs, 3/5 on the Medical Research Council strength scale (MRC) – left limbs, and dysphagia for liquids.http://bioclima.ro/Balneo231.pdf: ischemic strokeyoung patientneurorehabilitation
collection DOAJ
language English
format Article
sources DOAJ
author Maria-Gabriela Catană
Corina Roman-Filip
spellingShingle Maria-Gabriela Catană
Corina Roman-Filip
Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report
Balneo Research Journal
: ischemic stroke
young patient
neurorehabilitation
author_facet Maria-Gabriela Catană
Corina Roman-Filip
author_sort Maria-Gabriela Catană
title Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report
title_short Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report
title_full Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report
title_fullStr Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report
title_full_unstemmed Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report
title_sort neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report
publisher Romanian Association of Balneology, Editura Balneara
series Balneo Research Journal
issn 2069-7597
2069-7619
publishDate 2019-02-01
description Twenty percent of strokes occurring in young patients are represented by posterior ischemic strokes. Acute basilar occlusion is a devastating, life-threatening condition, with the highest mortality in young patients. We present the case of a 33-year-old female patient, without vascular risk factors or oral contraceptive treatment, admitted to our department through the emergency ward for comatose state – Glasgow Coma Scale (GCS) 11 points, headaches, right-sided hemiparesis, dizziness and vomiting, with acute onset. CT angiography was performed, which showed left vertebral artery with no flow in the intradural section and absent flow in the basilar artery. After more than 12 hours from onset, endarterectomy was excluded; initiation of treatment with heparin 1000 IU/hour was decided. MRI performed after 24 hours revealed: subacute median and left paramedian pontine ischemic stroke, subacute stroke in the base of the left midbrain peduncle. The following diagnosis was established: pontine ischemic stroke caused by two autoimmune diseases: thrombophilia and antiphospholipid antibody syndrome. Our patient started rehabilitation very early and was discharged with the following neurological sequelae: tetraparesis with the predominance of left hemiparesis: 4/5 on the Medical Research Council strength scale (MRC) – right limbs, 3/5 on the Medical Research Council strength scale (MRC) – left limbs, and dysphagia for liquids.
topic : ischemic stroke
young patient
neurorehabilitation
url http://bioclima.ro/Balneo231.pdf
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