Outcomes of acute basilar artery occlusion—real‐world experience in a middle‐income country

Abstract

Objectives Our goal was to describe outcomes in a single‐center, real‐world series of patients with acute basilar artery occlusion in a middle‐income country. In addition, we assessed potential outcome predictors. Material and Methods Data from 28 patients were retrospectively reviewed. The primary outcome was death until last follow‐up. Other outcomes were rates of favorable outcome until last follow‐up and rates of intracranial hemorrhage. Outcomes were compared in subgroups according to several variables, including reperfusion (REP group) or no reperfusion (NOREP group) interventions, with chi‐squared, Fisher's exact test, or Mann–Whitney tests. Results The rate of overall intrahospital death was 46%. Death until last follow‐up occurred in 8/17 (47%) in the REP and in 7/11 (63%) of the NOREP group. Favorable outcomes were observed in 35.7% of the patients: 8/17 (47%) in REP and in 2/11 (18.1%) in NOREP. NIH stroke scale scores were significantly lower in patients with favorable outcomes. Intracranial hemorrhage was observed in 6/28 (21.4%) of the patients (all in REP group). Twenty patients were treated with anticoagulants within the first 24 h. No hemorrhage was observed in those treated with enoxaparin, while three occurred in subjects treated with unfractionated heparin. Conclusion Together with other series, our results underscore the relevance of NIH stroke scale at admission as a prognostic marker, the importance of reperfusion to improve outcomes, and the need of clinical trials to compare the impact of treatment with anticoagulants within first 24 h in basilar artery occlusion.

Top of the Basilar Syndrome: A Case Report of a Healthy Young Woman and Literature Review

“…Ahn et al reported an incidence of 8.5% of TBS in a population of who experienced acute ischemic stroke in the posterior circulation during the study [ 2 ]. Borelli Del Guerra et al conducted a study on mortality in patients who did not receive reperfusion therapy, resulting in an in-hospital mortality rate of 45.4% and a cumulative mortality rate of 63.6% at the last follow-up [ 7 ].…”

“…The etiology of stroke was defined according to the Trial of Org 10.172 in Acute Stroke Treatment (TOAST) classification, it was determined as a stroke of undetermined etiology due to the negative results obtained from the examinations and tests performed [ 7 ].…”

“…In the study by Borelli Del Guerra et al, favorable outcomes were observed in 35.7% of patients, 47% of whom received reperfusion therapy and 18.1% of whom did not [ 7 ].…”