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Chronic basilar artery occlusion: a retrospective monocentric study

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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.

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Authors and Affiliations

  1. Departement of Neurology, Klinikum Kassel, Mönchebergstraße 41-43, 34125, Kassel, Germany

    Christian Roth, Andreas Ferbert & Johannes Matthaei

  2. Departement of Neurology, Philipps-Marburg University, Marburg, Germany

    Christian Roth

  3. Kassel School of Medicine, Kassel, Germany

    Rosa Yavuz & Carolin Maschita

Authors
  1. Christian Roth
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  2. Rosa Yavuz
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  3. Carolin Maschita
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  4. Andreas Ferbert
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  5. Johannes Matthaei
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Correspondence to Christian Roth.

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The study has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Roth, C., Yavuz, R., Maschita, C. et al. Chronic basilar artery occlusion: a retrospective monocentric study. J Neurol (2024). https://doi.org/10.1007/s00415-024-12375-4

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  • DOI: https://doi.org/10.1007/s00415-024-12375-4

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