Sakarya Tıp Dergisi (Sep 2021)

The Effect of Clinical and Radiological Features on Prognosis in the Top of The Basilar Syndrome

  • Zeynep Özözen Ayas,
  • Dilcan Kotan,
  • Kıyasettin Asil

DOI
https://doi.org/10.31832/smj.937034
Journal volume & issue
Vol. 11, no. 3
pp. 639 – 646

Abstract

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Objective: The ‘top of the basilar syndrome’ (TOBS) may occur when an embolus impacts in the distal basilar artery. We aimed to investigate the relationship between the clinical, radiological parameters of TOBS, its prognosis, and mortality rates, in Xxxxxxx, Turkey. Materials and Methods: Age, sex, presenting symptoms, National Institutes of Health Stroke Scores (NIHSS), infratentorial infarct volume (IIV), supratentorial infarct volume (SIV) lenght of stay (LOS) in neurology clinic and intensive care unit (ICU), the duration of mechanical ventilation (MV) and mortality were recorded. Results: Thirty-one patients (18 female,13 male) with diagnosed TOBS were included. The frequency was 2.2% among 1379 patients within 2,5years. The mean age was 69.0±12.1years. According to NIHSS, 11 (35.5%) patients had mild stroke, 16 (51.6%) moderate, and 4 (12.9%) severe stroke. The mean IIV was 8.84±10.44mm3 (0.17-33.88), SIV was 15.11±22.32mm3 (0.11-87.91). The average LOS in neurology clinic was 6.0±3.6, in ICU was 40.8±40.3days. Twenty-one (67.7%) patients needed to be in an ICU. Patients admitted to the ICU had significantly higher decreased level of consciousness (DLC) and visual abnormalities, NIHSS, IIV.(p0.05) 13/21 patients admitted to the ICU required MV. The mean duration of MV was 33.8±45.3days. DLC, ataxia, visual abnormalities as an initial symptoms, NIHSS, IIV were higher among patients who required MV compared with who did not. The mortality rate was 32.3%. NIHSS, LOS in clinic and ICU, the duration of MV of patients who died were statistically higher.(p0.05) Conclusions: It is important to determine effective parameters in order to prognose TOBS which is a rare stroke syndrome.

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