Reverse Locked-In Syndrome.
Reverse Locked-In Syndrome.
复制标题
反向锁定综合症。
DOI：
10.1007/s12028-017-0391-x
复制
发表时间：
2017-08
影响因子：
3.5
通讯作者：
Edlow BL
中科院分区：
文献类型：
--
作者：
Raibagkar P;Chavali RV;Kaplan TB;Kim JA;Nitka MV;Chou SH;Edlow BL
基底动脉闭塞可引起闭锁综合征，其特征是四肢瘫痪、无音和通过眼球运动交流受限。在这里，我们描述了一种与基底动脉顶部血管内再通相关的罕见卒中综合征：“反向闭锁综合征”。我们报告的情况下，患者与非典型神经功能缺损引起的急性缺血性中风的脑干被盖。我们通过将MRI数据映射到脑干图谱上，对患者的梗死进行神经解剖定位。一个61岁的男人提出急性昏迷和四肢瘫痪，由于上基底动脉闭塞。他接受了紧急血管内血栓切除术，并在血栓栓塞后4小时43分钟成功地重新通通了基底动脉。患者四肢恢复了意识和有目的的运动，但术后神经学检查显示双侧上睑下垂伴完全的瞳孔和动眼肌麻痹。磁共振成像显示双侧动眼核在中脑被盖梗塞。在9个月的随访中，他有异眼和共轭注视障碍，但仍在家中生活，在进行所有日常生活活动时需要最少的帮助。由于患者的缺陷与闭锁综合征中描述的完全相反，我们提出“反向闭锁综合征”一词来描述这种以双侧上睑下垂、瞳孔无反应性和眼球麻痹为特征的神经系统实体，并保留意识和肢体运动功能。
Basilar artery occlusion can cause locked-in syndrome, which is characterized by quadriplegia, anarthria and limited communication via eye movements. Here, we describe an uncommon stroke syndrome associated with endovascular recanalization of the top-of-the-basilar artery: “reverse locked-in syndrome”. We report the case of a patient with atypical neurological deficits caused by acute ischemic stroke of the brainstem tegmentum. We perform neuroanatomic localization of the patient’s infarcts by mapping the MRI data onto a brainstem atlas. A 61-year-old man presented with acute coma and quadriplegia due to top-of-the-basilar artery occlusion. He underwent emergent endovascular thrombectomy, with successful recanalization of the basilar artery at 4 hours and 43 minutes post-ictus. The patient regained consciousness and purposeful movement in all 4 extremities, but the post-procedure neurological examination demonstrated bilateral ptosis with complete pupillary and oculomotor paralysis. Magnetic resonance imaging revealed infarction of the bilateral oculomotor nuclei in the midbrain tegmentum. At nine-month follow-up, he had anisocoria and dysconjugate gaze but was living at home and required minimal assistance in performing all activities of daily living. Since the patient’s deficits were the exact opposite of those described in locked-in syndrome, we propose the term “reverse locked-in syndrome” to describe this neurological entity characterized by bilateral ptosis, non-reactive pupils and ophthalmoplegia with preservation of consciousness and extremity motor function.
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影响因子：
3.5
作者：
Edlow, Brian L.;Giacino, Joseph T.;Hirschberg, Ronald E.;Gerrard, Jason;Wu, Ona;Hochberg, Leigh R.
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通讯作者：
ADAMS, RD
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158.5
作者：
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